Provider Demographics
NPI:1770236358
Name:MEDICAL ASSOCIATES OF ENGLEWOOD, PC
Entity Type:Organization
Organization Name:MEDICAL ASSOCIATES OF ENGLEWOOD, PC
Other - Org Name:ENGLEWOOD HEALTH PHYSICIAN NETWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHA'LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-894-3012
Mailing Address - Street 1:30 MONTGOMERY ST STE 720
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-3834
Mailing Address - Country:US
Mailing Address - Phone:646-517-1255
Mailing Address - Fax:
Practice Address - Street 1:22-18 BROADWAY STE 105
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-3016
Practice Address - Country:US
Practice Address - Phone:551-444-6010
Practice Address - Fax:201-568-7975
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICAL ASSOCIATES OF ENGLEWOOD, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-02
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty