Provider Demographics
NPI:1932820826
Name:IMEM MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:IMEM MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HILLEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PELTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-886-5791
Mailing Address - Street 1:1091 RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5641
Mailing Address - Country:US
Mailing Address - Phone:732-886-5791
Mailing Address - Fax:
Practice Address - Street 1:1091 RIVER AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5641
Practice Address - Country:US
Practice Address - Phone:732-886-5791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-08
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care