Provider Demographics
NPI:1912447509
Name:IDLENESS ELIMINATORS
Entity Type:Organization
Organization Name:IDLENESS ELIMINATORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SIMEON
Authorized Official - Middle Name:
Authorized Official - Last Name:MERTYL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-242-2810
Mailing Address - Street 1:826 WESTFIELD AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208-1225
Mailing Address - Country:US
Mailing Address - Phone:908-242-2810
Mailing Address - Fax:888-422-1173
Practice Address - Street 1:826 WESTFIELD AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07208-1225
Practice Address - Country:US
Practice Address - Phone:908-242-2810
Practice Address - Fax:888-422-1173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty