Provider Demographics
NPI:1629025028
Name:NEWARK BETH ISRAEL EMERGENCY ROOM DEPARTMENT
Entity Type:Organization
Organization Name:NEWARK BETH ISRAEL EMERGENCY ROOM DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:MERTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-926-3826
Mailing Address - Street 1:PO BOX 785786
Mailing Address - Street 2:NEWARK BETH ISRAEL EMERGENCY ROOM DEPARTMENT
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0001
Mailing Address - Country:US
Mailing Address - Phone:732-557-7160
Mailing Address - Fax:732-557-7109
Practice Address - Street 1:201 LYONS AVENUE
Practice Address - Street 2:NEWARK BETH ISRAEL MEDICAL CENTER
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-2094
Practice Address - Country:US
Practice Address - Phone:973-926-7000
Practice Address - Fax:732-557-7109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ037931Medicare ID - Type Unspecified