Organization
EASTERN EMERGENCY PHYSICIANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL HARRIS MD (PRESIDENT)
(469) 401-2386
Entity
Organization
Contact information
Practice address
865 STONE ST, RAHWAY, NJ 07065-2742
(732) 381-4200
Mailing address
13737 NOEL RD, STE 1600, DALLAS, TX 75240-1331
(469) 401-2386
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7959401
—
NJ
Enumeration date
05/09/2006
Last updated
12/23/2013
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