Irvington Emergent Care

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA042750NJ Issued in NJ

Legal business name

IRVINGTON EMERGENT CARE

Practice address

12 Krotik PL
Irvington, NJ 07111-1708

Phone

(973) 373-3000

Fax

(973) 399-8880

NPI assigned

Dec 11, 2012

Last updated

Dec 11, 2012By 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

Rudolph Willis, M.D.NPI 1104887819

Title

Ceo

Phone

(973) 373-3000

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Rudolph Willis, MD

  • Family Medicine Physician
  • Irvington, NJ
  • NPI 1104887819

  Specialist

  NPD Authorized official

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

{
    "created_epoch": "1355184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355184000000",
    "number": "1578808952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 KROTIK PL",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071111708",
            "telephone_number": "973-373-3000",
            "fax_number": "973-399-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 KROTIK PL",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071111708",
            "telephone_number": "973-373-3000",
            "fax_number": "973-399-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRVINGTON EMERGENT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-11",
        "last_updated": "2012-12-11",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "RUDOLPH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "973-373-3000",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA042750NJ",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0887307",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Innovative Minds LLC (Innovative Minds)
• Irvington Adult Day Care Center
• Irvington Board of Education
• Irvington Counseling Center, Inc.
• Irvington Department of Health and Welfare
• Irvington Emergent Care and Rehabilitation Center Inc.
• Irvington Eye Care Limited Liability Company
• Irvington Family Dental LLC
• Irvington Family Dentistry, PA
• Irvington Family Medicine

• Specialist in Irvington, NJ
• Providers in Irvington, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.