Elizabeth Medical Diagnostic Associates Inc

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

MAO73645 Issued in NJ

Legal business name

ELIZABETH MEDICAL DIAGNOSTIC ASSOCIATES INC

Practice address

469 Morris Ave Ste 1
Elizabeth, NJ 07208-2904

Phone

(908) 351-3535

Fax

(908) 351-0161

NPI assigned

Mar 23, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Elena Dragun, MD

Title

Ceo

Phone

(908) 351-3535

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1269302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269388800000",
    "number": "1144544958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "469 MORRIS AVE STE 1",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072082904",
            "telephone_number": "908-351-3535",
            "fax_number": "908-351-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "469 MORRIS AVE STE 1",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072082904",
            "telephone_number": "908-351-3535",
            "fax_number": "908-351-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH MEDICAL DIAGNOSTIC ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-23",
        "last_updated": "2010-03-24",
        "status": "A",
        "authorized_official_last_name": "DRAGUN",
        "authorized_official_first_name": "ELENA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "908-351-3535",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NJ",
            "license": "MAO73645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• Multi-Specialty Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; 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.