Basic Information
Provider Information | |||||||||
NPI: | 1467496786 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | KESSLER EMERGENCY ROOM PHYSICIANS ASSOCIATES PA | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 600 S WHITE HORSE PIKE | ||||||||
Address2: | KESSLER MEMORIAL HOSPITAL E.R. | ||||||||
City: | HAMMONTON | ||||||||
State: | NJ | ||||||||
PostalCode: | 080372014 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6095616700 | ||||||||
FaxNumber: | 6095673942 | ||||||||
Practice Location | |||||||||
Address1: | 600 S WHITE HORSE PIKE | ||||||||
Address2: | KESSLER MEMORIAL HOSPITAL E.R. | ||||||||
City: | HAMMONTON | ||||||||
State: | NJ | ||||||||
PostalCode: | 080372014 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6095616700 | ||||||||
FaxNumber: | 6095673942 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/16/2006 | ||||||||
LastUpdateDate: | 09/17/2007 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | ZWIEBEL | ||||||||
AuthorizedOfficialFirstName: | WILLIAM | ||||||||
AuthorizedOfficialMiddleName: | A | ||||||||
AuthorizedOfficialTitleorPosition: | DIERCTOR | ||||||||
AuthorizedOfficialTelephone: | 6095616700 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: | DR. | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: | D.O. | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X |   |   | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |   |
No ID Information.