Immedi-Care PA

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

IMMEDI-CARE PA

Practice address

360 Avenue P FL 3
Newark, NJ 07105

Phone

(973) 643-8383

Fax

(973) 491-6099

NPI assigned

May 30, 2008

Last updated

Jul 18, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Dimitra Denise Pallis

Title

Director of Credentialing

Phone

(201) 874-9084

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531872000000",
    "number": "1063670578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1296",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070120796",
            "telephone_number": "973-643-8383",
            "fax_number": "973-491-6099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 AVENUE P FL 3",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07105",
            "telephone_number": "973-643-8383",
            "fax_number": "973-491-6099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMEDI-CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-30",
        "last_updated": "2018-07-18",
        "status": "A",
        "authorized_official_last_name": "PALLIS",
        "authorized_official_first_name": "DIMITRA",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "201-874-9084",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Ikechi
• Vivian Ikwuako
• Omobola Muyinat Ilesanmi, APN
• Fariha Ilyas, M.D.
• Im So Yoga
• Immedicare
• Catherine Walsh Imossi, MD, MBA
• Nicholas Sebastian-Jude Imperato, DO, MPH
• Imperial Caregivers LLC
• Imperial Medical Group Limited Liability Company

• Health Service Clinic/Center in Newark, NJ
• Providers in Newark, NJ by specialty
• Health Service Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.