Basic Information
| Provider Information | |||||||||
| NPI: | 1104862630 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAPE EMERGENCY PHYSICIANS PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 7837 | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176047837 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8444930968 | ||||||||
| FaxNumber: | 8442899450 | ||||||||
| Practice Location | |||||||||
| Address1: | 2 STONE HARBOR BLVD | ||||||||
| Address2: | CAPE REGIONAL MEDICAL CENTER (EMERGENCY DEPT) | ||||||||
| City: | CAPE MAY COURT HOUSE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082102138 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6094632339 | ||||||||
| FaxNumber: | 6094632946 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2006 | ||||||||
| LastUpdateDate: | 08/30/2022 | ||||||||
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| AuthorizedOfficialLastName: | RUSKEY | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6094632339 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
| NPICertificationDate: | 08/16/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 3310604 | 05 | NJ | MEDICAID |