Provider Demographics
NPI:1598841124
Name:JEFF PALEY MD PC
Entity type:Organization
Organization Name:JEFF PALEY MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:EVAN
Authorized Official - Last Name:PALEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD MPH
Authorized Official - Phone:201-503-0833
Mailing Address - Street 1:177 NORTH DEAN STREET
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2522
Mailing Address - Country:US
Mailing Address - Phone:201-503-0833
Mailing Address - Fax:201-503-0844
Practice Address - Street 1:184 E 70TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5154
Practice Address - Country:US
Practice Address - Phone:212-734-6570
Practice Address - Fax:201-503-0844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJMA75257207R00000X
NYNY211534207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEM741Medicare PIN
G90470Medicare UPIN