Provider Demographics
NPI:1861449613
Name:PARAMUS EMERGENCY SERVICES, PC
Entity Type:Organization
Organization Name:PARAMUS EMERGENCY SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:PINELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-805-1300
Mailing Address - Street 1:PO BOX 827450
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-7450
Mailing Address - Country:US
Mailing Address - Phone:904-805-1300
Mailing Address - Fax:904-805-1302
Practice Address - Street 1:230 E RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-4131
Practice Address - Country:US
Practice Address - Phone:201-967-4000
Practice Address - Fax:904-805-1302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ610063200OtherDEPT OF LABOR
NJ8908206Medicaid
NJCK2591OtherRAILROAD MEDICARE
NJ610063200OtherDEPT OF LABOR
NJ=========OtherBLUE SHIELD