1225304736 NPI number — EVEREST MEDICAL CENTER OF NORTH BERGEN LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225304736 NPI number — EVEREST MEDICAL CENTER OF NORTH BERGEN LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EVEREST MEDICAL CENTER OF NORTH BERGEN LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225304736
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/29/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
195 US HIGHWAY 46
Provider Second Line Business Mailing Address:
STE 4
Provider Business Mailing Address City Name:
TOTOWA
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07512-1833
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-650-2009
Provider Business Mailing Address Fax Number:
253-650-2009

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7823 BERGENLINE AVE
Provider Second Line Business Practice Location Address:
2ND FLOOR
Provider Business Practice Location Address City Name:
NORTH BERGEN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07047-4942
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-868-9449
Provider Business Practice Location Address Fax Number:
201-868-7497
Provider Enumeration Date:
03/29/2012

Additional Information

Authorized Official

Authorized Official Last Name:
MAHMOUD
Authorized Official First Name:
MAGDY
Authorized Official Middle Name:
F
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
973-650-2009

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QC1500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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