Organization
NORTHERN NEW JERSEY EMERGENCY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON RANDOL (ENROLLMENT SPECIALIST)
(616) 464-0027
Entity
Organization
Contact information
Practice address
703 MAIN ST, PATERSON, NJ 07503-2621
(973) 754-2000
Mailing address
703 MAIN ST, PATERSON, NJ 07503-2621
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0058980
—
NJ
Enumeration date
09/18/2007
Last updated
09/18/2007
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