Provider Demographics
NPI:1861483190
Name:EMERGENCY MEDICAL ASSOCIATES LLP
Entity Type:Organization
Organization Name:EMERGENCY MEDICAL ASSOCIATES LLP
Other - Org Name:EMERGENCY MEDICAL ASSOCIATES, LLP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDONI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:262-928-2475
Mailing Address - Street 1:6400 INDUSTRIAL LOOP
Mailing Address - Street 2:
Mailing Address - City:GREENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53129-2452
Mailing Address - Country:US
Mailing Address - Phone:414-423-4100
Mailing Address - Fax:414-423-4134
Practice Address - Street 1:725 AMERICAN AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-5031
Practice Address - Country:US
Practice Address - Phone:262-928-2475
Practice Address - Fax:262-928-5697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-04
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CS8103OtherMEDICARE RAILROAD
WI32696300Medicaid
WI32696300Medicaid
WI000068150Medicare PIN