Organization
MEDEMERGE LLC
Active
Other names
Medemerge Medical Associates, PA
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA BERSHAD (SENIOR VICE PRESIDENT)
(732) 212-0051
Entity
Organization
Contact information
Practice address
1005 N WASHINGTON AVE, GREEN BROOK, NJ 08812-2619
(732) 968-8900
(732) 968-4609
Mailing address
1005 N WASHINGTON AVE, GREEN BROOK, NJ 08812-2619
(732) 968-8900
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
057453
MEDICARE GROUP PROVIDER NUMBER
NJ
05
—
8805903
—
NJ
Enumeration date
05/09/2007
Last updated
03/31/2023
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