Ed Medical Associates, Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MA068121 Issued in NJ

Legal business name

ED MEDICAL ASSOCIATES, INC

Practice address

140 Grand Ave
Englewood, NJ 07631-6581

Phone

(201) 569-9010

Fax

(201) 541-7942

NPI assigned

Dec 28, 2015

Last updated

Dec 28, 2015By 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

Dr. Eli Djebiyan, MDNPI 1841215969

Title

Owner

Phone

(201) 569-9010

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eli S Djebiyan, MD

  • Internal Medicine Physician
  • Englewood, NJ
  • NPI 1841215969
  Authorized official Same address or phone

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

{
    "created_epoch": "1451260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451260800000",
    "number": "1245695766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 GRAND AVE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076316581",
            "telephone_number": "201-569-9010",
            "fax_number": "201-541-7942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 GRAND AVE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076316581",
            "telephone_number": "201-569-9010",
            "fax_number": "201-541-7942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ED MEDICAL ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-28",
        "last_updated": "2015-12-28",
        "status": "A",
        "authorized_official_last_name": "DJEBIYAN",
        "authorized_official_first_name": "ELI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-569-9010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA068121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Englewood, NJ
• Providers in Englewood, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2015; 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.