Provider Demographics
NPI:1215965231
Name:EMERGENCY PHYSICIAN ASSOCIATES OF SOUTH JERSEY P C
Entity type:Organization
Organization Name:EMERGENCY PHYSICIAN ASSOCIATES OF SOUTH JERSEY P C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ISTVAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-686-4300
Mailing Address - Street 1:307 S EVERGREEN AVE
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-2739
Mailing Address - Country:US
Mailing Address - Phone:856-686-4316
Mailing Address - Fax:865-291-3254
Practice Address - Street 1:101 CARNIE BLVD
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-1548
Practice Address - Country:US
Practice Address - Phone:856-686-4300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3440508Medicaid
NJ3151000Medicaid
NJ3384608Medicaid
NJ3151107Medicaid
NJ3440605Medicaid
NJ0090361Medicaid
NJ3384705Medicaid
NJ3384802Medicaid
NJ3431509Medicaid
NJ3440800Medicaid
NJ3440800Medicaid