NPIMap

Organization Active NPI

NJ Pain Rehabilitation Group, PC

  • Family Medicine Physician
  • Bayonne, NJ
National Provider Identifier
1023281284
Registry record updated Oct 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MB057523 Issued in NJ
Legal business name
NJ PAIN REHABILITATION GROUP, PC
Practice address
631 Broadway
First Floor
Bayonne, NJ 07002
Phone
(973) 751-2060
NPI assigned
Apr 9, 2008
Last updated
Oct 2, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2008

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

Authorized official

Name
Dr. Antonio Ciccone, DONPI 1750413464
Title
Owner
Phone
(973) 751-2060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MB057523 NJ Primary

Addresses

Primary practice location

631 Broadway
First Floor
Bayonne, NJ 07002

Mailing address

885 Broadway Pmb168
Pmb168
Bayonne, NJ 07002
Phone (973) 751-2060

National Provider Directory

National Provider Directory

Locations

631 Broadway
Ste 1
Bayonne, NJ 07002

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222905600000",
    "number": "1023281284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 BROADWAY PMB168",
            "address_2": "PMB168",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "07002",
            "telephone_number": "973-751-2060",
            "fax_number": "973-751-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 BROADWAY",
            "address_2": "FIRST FLOOR",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "07002",
            "telephone_number": "973-751-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NJ PAIN REHABILITATION GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-09",
        "last_updated": "2008-10-02",
        "status": "A",
        "authorized_official_last_name": "CICCONE",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-751-2060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB057523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2008; 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.