Provider Demographics
NPI:1154671501
Name:PHYSICIAN PARTNERS OF ENGLEWOOD, PC
Entity type:Organization
Organization Name:PHYSICIAN PARTNERS OF ENGLEWOOD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. DIRECTOR OF FINANCIAL PLANNING
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KASEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-894-3853
Mailing Address - Street 1:375 ENGLE ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-1823
Mailing Address - Country:US
Mailing Address - Phone:201-608-2136
Mailing Address - Fax:201-894-5209
Practice Address - Street 1:2 JOURNAL SQUARE
Practice Address - Street 2:2ND FLR
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306
Practice Address - Country:US
Practice Address - Phone:201-963-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0812552Medicaid
NJ257155OtherNJ MEDICARE