East West Medical Group LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD058888L Issued in PA

Legal business name

EAST WEST MEDICAL GROUP LLC

Practice address

208 Lifeline Rd
Suite 102
Stroudsburg, PA 18360-6419

Phone

(570) 420-5435

Fax

(570) 420-5437

NPI assigned

Feb 28, 2007

Organization subpart

No

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

Authorized official

Name

Parvez Memon, MD

Title

Owner

Phone

(570) 420-5435

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/4328/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674691200000",
    "number": "1346377033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 LIFELINE RD",
            "address_2": "SUITE 102",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183606419",
            "telephone_number": "570-420-5435",
            "fax_number": "570-420-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 LIFELINE RD",
            "address_2": "SUITE 102",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183606419",
            "telephone_number": "570-420-5435",
            "fax_number": "570-420-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST WEST MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A",
        "authorized_official_last_name": "MEMON",
        "authorized_official_first_name": "PARVEZ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-420-5435",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD058888L",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD066364L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017538850001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shuantise Dubose, OTR/L
• Emily Dwyer, PAC
• Heather Dymond, M.S. CCC-SLP
• Rachel Antoinette Earle, MD
• East Stroudsburg
• Eastern Poconos Internal Medicine
• Julieann Eckel
• Eckerd Corporation
• Kevin Connor Eddinger, MD
• Edge Medical Services

• Family Medicine Physician in Stroudsburg, PA
• Providers in Stroudsburg, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.