Provider Demographics
NPI:1013517044
Name:EXCELLENCE MEDICAL CARE, PC
Entity type:Organization
Organization Name:EXCELLENCE MEDICAL CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAGDALENA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYJAK
Authorized Official - Suffix:
Authorized Official - Credentials:BILLING MANAGER
Authorized Official - Phone:201-456-7363
Mailing Address - Street 1:PO BOX 211
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07407-0211
Mailing Address - Country:US
Mailing Address - Phone:862-520-5469
Mailing Address - Fax:201-595-0320
Practice Address - Street 1:110 S GROVE ST FL 2
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-4102
Practice Address - Country:US
Practice Address - Phone:862-520-5469
Practice Address - Fax:201-595-0320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty