OrganizationActive
Passaic River Physicians, LLC
NPI 1124788807 · Emergency Medicine Physician · Wayne, NJ
Provider details
- NPI number
- 1124788807
- Entity type
- Organization
- Primary specialty
- Emergency Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kim Larsen, Director of Credentialing(770) 874-5400
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(61/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
224 Hamburg Tpke
Wayne, NJ 07470-2168
Phone: (973) 942-6900
Street-level locationGet directions
Mailing address
5665 New Northside Dr Ste 320
Atlanta, GA 30328-5834
Registry dates
- Enumerated
- 2021-12-22
- Last updated
- 2021-12-22
- Certified
- 2021-12-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.