Provider Demographics
NPI:1427098763
Name:ELIZABETH EMERGENCY PHYSICIANS, L.L.C.
Entity type:Organization
Organization Name:ELIZABETH EMERGENCY PHYSICIANS, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:T
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-994-5263
Mailing Address - Street 1:66 W GILBERT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-4918
Mailing Address - Country:US
Mailing Address - Phone:732-212-0051
Mailing Address - Fax:732-212-0713
Practice Address - Street 1:225 WILLIAMSON STREET
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07207-3600
Practice Address - Country:US
Practice Address - Phone:908-257-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207P00000X, 207PP0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5506134OtherGHI
NJCI3012OtherRAILROAD MEDICARE
NJW3M98OtherWELLCHOICE
NJ2069262OtherAETNA
NJG1099898OtherOXFORD
NJ02041596OtherNY MEDICAID
NJ0218957OtherUNITED HEALTHCARE
NJ1125336OtherHORIZON NJ HEALTH
NJ7811403Medicaid
NJ20990OtherUNIVERSITY HEALTH PLANS
NJ2K3577OtherHEALTH NET OF THE NORTHEA
NJ022462Medicare PIN