Provider Demographics
NPI:1619990900
Name:EMERGENCY PHYSICIAN ASSOCIATES OF PENNSYLVANIA, PC
Entity Type:Organization
Organization Name:EMERGENCY PHYSICIAN ASSOCIATES OF PENNSYLVANIA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MURTAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-686-4316
Mailing Address - Street 1:307 SOUTH EVERGREEN AVE
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08095-2739
Mailing Address - Country:US
Mailing Address - Phone:856-686-4316
Mailing Address - Fax:856-848-8536
Practice Address - Street 1:300 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-2297
Practice Address - Country:US
Practice Address - Phone:717-633-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207P00000X
PA207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017419550008Medicaid
PA0017419550008Medicaid