Provider Demographics
NPI:1972569606
Name:TEANECK EMERGENCY PHYSICIANS PA
Entity Type:Organization
Organization Name:TEANECK EMERGENCY PHYSICIANS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWAB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-833-3229
Mailing Address - Street 1:PO BOX 13700 3765
Mailing Address - Street 2:TEANECK EMERGENCY PHYSICIANS PA
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19191-3765
Mailing Address - Country:US
Mailing Address - Phone:610-668-6471
Mailing Address - Fax:610-617-6280
Practice Address - Street 1:718 TEANECK ROAD
Practice Address - Street 2:HOLY NAME HOSPITAL
Practice Address - City:TEANECK
Practice Address - State:PA
Practice Address - Zip Code:07666
Practice Address - Country:US
Practice Address - Phone:201-833-3000
Practice Address - Fax:610-617-6280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7786301Medicaid
019927Medicare ID - Type Unspecified