Provider Demographics
NPI:1801408059
Name:NEW JERSEY SPORTS & EXPOSITION AUTHORITY E.M.S
Entity Type:Organization
Organization Name:NEW JERSEY SPORTS & EXPOSITION AUTHORITY E.M.S
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELO
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHINNICI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-460-4110
Mailing Address - Street 1:1 DEKORTE PARK PLAZA
Mailing Address - Street 2:
Mailing Address - City:LYNHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07071
Mailing Address - Country:US
Mailing Address - Phone:201-460-4110
Mailing Address - Fax:201-748-5134
Practice Address - Street 1:50 STATE ROUTE 120
Practice Address - Street 2:
Practice Address - City:EAST RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07073
Practice Address - Country:US
Practice Address - Phone:201-460-4110
Practice Address - Fax:201-485-5134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes341600000XTransportation ServicesAmbulance
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty