Provider Demographics
NPI:1538106257
Name:CENTRAL JERSEY EMERGENCY MEDICINE ASSOCIATES, PC
Entity Type:Organization
Organization Name:CENTRAL JERSEY EMERGENCY MEDICINE ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-294-2666
Mailing Address - Street 1:PO BOX 7200
Mailing Address - Street 2:CENTRAL JERSEY EMERG MED ASSOC PC
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-7200
Mailing Address - Country:US
Mailing Address - Phone:732-294-2666
Mailing Address - Fax:732-431-8267
Practice Address - Street 1:901 W MAIN ST
Practice Address - Street 2:CENTRASTATE MEDICAL CENTER
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2537
Practice Address - Country:US
Practice Address - Phone:732-294-2666
Practice Address - Fax:732-431-8267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2008-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3142604Medicaid
NJ110438Medicare PIN