Provider Demographics
NPI:1316272685
Name:DRX PARAMUS, LLC
Entity type:Organization
Organization Name:DRX PARAMUS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:MALIZIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-262-2010
Mailing Address - Street 1:8 DEERHILL DR
Mailing Address - Street 2:
Mailing Address - City:HO HO KUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07423-1706
Mailing Address - Country:US
Mailing Address - Phone:201-262-2010
Mailing Address - Fax:201-262-2040
Practice Address - Street 1:67 E RIDGEWOOD AVE
Practice Address - Street 2:UNIT C
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3623
Practice Address - Country:US
Practice Address - Phone:201-262-2010
Practice Address - Fax:201-262-2040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08499300261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care