Executive Medical Services LLC

Primary specialty

Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X

Legal business name

EXECUTIVE MEDICAL SERVICES LLC

Practice address

99 Chamberlain Ave
Elmwood Park, NJ 07407-1411

Phone

(201) 230-9594

Fax

(201) 845-6435

NPI assigned

Oct 17, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jose Lopez

Title

President

Phone

(201) 845-6433

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720168412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 CHAMBERLAIN AVE",
            "city": "ELMWOOD PARK",
            "state": "NJ",
            "postal_code": "074071411",
            "telephone_number": "201-230-9594",
            "fax_number": "201-845-6435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 CHAMBERLAIN AVE",
            "city": "ELMWOOD PARK",
            "state": "NJ",
            "postal_code": "074071411",
            "telephone_number": "201-230-9594",
            "fax_number": "201-845-6435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE MEDICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-845-6433",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elmwood Park Board of Education
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• Yan Gao Fan, MD
• Wilfrid Fehrle, M.D.
• Liliya Feldman, M.D.

• Mobile Radiology Clinic/Center in Elmwood Park, NJ
• Providers in Elmwood Park, NJ by specialty
• Mobile Radiology Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.