Organization Active NPI

Elizabeth Bayway Medical Center, LLC

  • Emergency Medicine Physician
  • Elizabeth, NJ
National Provider Identifier
1083960249
Registry record updated Aug 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MA079138 Issued in NJ
Legal business name
ELIZABETH BAYWAY MEDICAL CENTER, LLC
Practice address
636 Bayway Ave
Elizabeth, NJ 07202-2613
Phone
(908) 994-1900
Fax
(908) 994-0900
NPI assigned
Jul 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2012

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

Authorized official

Name
Dr. Keyur Ajbani, M.D.
Title
Owner
Phone
(908) 994-1900

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X 25MA079138 NJ Primary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X

Addresses

Primary practice location

636 Bayway Ave
Elizabeth, NJ 07202-2613

Mailing address

636 Bayway Ave
Elizabeth, NJ 07202-2613
Phone (908) 994-1900

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1343174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346371200000",
    "number": "1083960249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 BAYWAY AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072022613",
            "telephone_number": "908-994-1900",
            "fax_number": "908-994-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 BAYWAY AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072022613",
            "telephone_number": "908-994-1900",
            "fax_number": "908-994-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH BAYWAY MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-25",
        "last_updated": "2012-08-31",
        "status": "A",
        "authorized_official_last_name": "AJBANI",
        "authorized_official_first_name": "KEYUR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-994-1900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA079138",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2012; 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.