Lodespoto Medical of NJ LLC

Primary specialty

Neuroradiology PhysicianTaxonomy code 2085N0700X

License

25MA09300800 Issued in NJ

Legal business name

LODESPOTO MEDICAL OF NJ LLC

Practice address

225 Passaic St
Passaic, NJ 07055-6414

Phone

(201) 335-8909

Fax

(844) 840-7352

NPI assigned

Sep 22, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mark J Lodespoto, MD

Title

Owner

Phone

(201) 335-8909

Specialties & licenses 1

Addresses

Other names 1

• Eyecuity of New Jersey Former legal business name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555459200000",
    "number": "1013319052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 958",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117760811",
            "telephone_number": "201-335-8909",
            "fax_number": "844-840-7352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 PASSAIC ST",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070556414",
            "telephone_number": "201-335-8909",
            "fax_number": "844-840-7352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LODESPOTO MEDICAL OF NJ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-22",
        "last_updated": "2019-04-17",
        "status": "A",
        "authorized_official_last_name": "LODESPOTO",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-335-8909",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Neuroradiology",
            "state": "NJ",
            "license": "25MA09300800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eyecuity of New Jersey",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Neuroradiology Physician in Passaic, NJ
• Providers in Passaic, NJ by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.