Provider Demographics
NPI:1427285709
Name:ATLANTIC EMERGENCY ASSOCIATES - HAMMONTON SED LLC
Entity type:Organization
Organization Name:ATLANTIC EMERGENCY ASSOCIATES - HAMMONTON SED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WALSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-639-2747
Mailing Address - Street 1:PO BOX 411017
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-1020
Mailing Address - Country:US
Mailing Address - Phone:610-639-2747
Mailing Address - Fax:
Practice Address - Street 1:219 N WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-1896
Practice Address - Country:US
Practice Address - Phone:610-639-2747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-15
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty