Organization
CLIFFSIDE MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN S CHOUAKE M.D. (PRESIDENT)
(201) 945-6500
Entity
Organization
Contact information
Practice address
663 PALISADE AVE, CLIFFSIDE PARK, NJ 07010-3012
(201) 945-6500
(201) 945-1157
Mailing address
663 PALISADE AVE STE 101, CLIFFSIDE PARK, NJ 07010-3098
(201) 945-6500
(201) 945-1157
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
208D00000X
General Practice Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0820903
—
NJ
Enumeration date
10/20/2006
Last updated
10/11/2023
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