# HEALTH EAST MEDICAL GROUP PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235577172
- **Authorized official:** ANSON MOISE (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (201) 871-4000

## Contact information

- **Practice address:** 54 S DEAN ST, ENGLEWOOD, NJ 07631-3514
- **Practice address phone:** (201) 871-4000
- **Mailing address:** 54 S DEAN ST, ENGLEWOOD, NJ 07631-3514

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 25MA08596900 | NJ | Yes |
| 208VP0000X | Pain Medicine Physician | 25MA08595100 | NJ | — |
| 213E00000X | Podiatrist | 25MD00304200 | NJ | — |

## Other

- **Enumeration date:** 06/13/2013
- **Last updated:** 12/09/2014