Organization Active NPI

West Jersey Medical Service Inc

  • Internal Medicine Physician
  • North Bergen, NJ
National Provider Identifier
1295956225
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA69092 Issued in NJ
Legal business name
WEST JERSEY MEDICAL SERVICE INC
Practice address
500 78TH St
2ND Floor
North Bergen, NJ 07047-4927
Phone
(201) 868-9449
Fax
(201) 868-7497
NPI assigned
May 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Dr. Ehab M Faheid, M.D.NPI 1417915521
Title
President
Phone
(201) 868-9449

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X MA69092 NJ Primary

Addresses

Primary practice location

500 78TH St
2ND Floor
North Bergen, NJ 07047-4927

Mailing address

500 78TH St
2ND Floor
North Bergen, NJ 07047-4927
Phone (201) 868-9449

Other identifiers 1

IdentifierTypeStateIssuer
7995202MedicaidNJ

National Provider Directory

National Provider Directory

Locations

500 78th St
#2
North Bergen, NJ 07047
Phone (201) 868-9449

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1295956225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 78TH ST",
            "address_2": "2ND FLOOR",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070474927",
            "telephone_number": "201-868-9449",
            "fax_number": "201-868-7497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 78TH ST",
            "address_2": "2ND FLOOR",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070474927",
            "telephone_number": "201-868-9449",
            "fax_number": "201-868-7497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST JERSEY MEDICAL SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "FAHEID",
        "authorized_official_first_name": "EHAB",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-868-9449",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA69092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7995202",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bergen, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.