NPIMap

Organization Active NPI

Intermedico LLC

  • Clinic/Center
  • Glen Rock, NJ
National Provider Identifier
1023760667
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
INTERMEDICO LLC
Practice address
835 Harristown Rd
Glen Rock, NJ 07452-2424
Phone
(201) 857-8416
NPI assigned
Jan 25, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Authorized official

Name
Andrew DingNPI 1508868019
Title
Owner
Phone
(917) 204-2722

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

835 Harristown Rd
Glen Rock, NJ 07452-2424

Mailing address

835 Harristown Rd
Glen Rock, NJ 07452-2424
Phone (201) 857-8416

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643068800000",
    "number": "1023760667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 HARRISTOWN RD",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074522424",
            "telephone_number": "201-857-8416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 HARRISTOWN RD",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074522424",
            "telephone_number": "201-857-8416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMEDICO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-20",
        "status": "A",
        "authorized_official_last_name": "DING",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-204-2722"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Rock, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.