Organization
HEALTH EAST MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANSON MOISE (DIRECTOR OF OPERATIONS)
(201) 871-4000
Entity
Organization
Contact information
Practice address
54 S DEAN ST, ENGLEWOOD, NJ 07631-3514
(201) 871-4000
Mailing address
54 S DEAN ST, ENGLEWOOD, NJ 07631-3514
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
25MA08596900
NJ
208VP0000X
Pain Medicine Physician
25MA08595100
NJ
213E00000X
Podiatrist
25MD00304200
NJ
Other
Enumeration date
06/13/2013
Last updated
12/09/2014
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