Divine Grace Medical Services

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

DIVINE GRACE MEDICAL SERVICES

Practice address

159 Bloomfield Ave
Nutley, NJ 07110-3135

Phone

(973) 235-1772

Fax

(973) 235-1774

NPI assigned

Jul 26, 2007

Last updated

Jul 26, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marciano Figueroa

Title

Physician

Phone

(973) 235-1772

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Conrado A Boja III, M.D.

  • Family Medicine Physician
  • Teaneck, NJ
  • NPI 1255399408
  NPD (past)

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185408000000",
    "number": "1033309968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 BLOOMFIELD AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071103135",
            "telephone_number": "973-235-1772",
            "fax_number": "973-235-1774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 BLOOMFIELD AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071103135",
            "telephone_number": "973-235-1772",
            "fax_number": "973-235-1774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE GRACE MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2007-07-26",
        "status": "A",
        "authorized_official_last_name": "FIGUEROA",
        "authorized_official_first_name": "MARCIANO",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "973-235-1772"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellen R Dichiara, APN-C
• Angela Dicostanzo
• Diego Ruiz DC LLC (Options Physical Medicine and Rehabilitation Center)
• Michael Digangi
• Laurie Jo Dimichele-Smorra, DMD
• Michal Milow Divney, LCSW
• Sarah A Dodge, MD
• Eileen Maria Doyle, MSW
• Dr Anthony M Pastena LLC
• Robert Drazic, DO

• Internal Medicine Physician in Nutley, NJ
• Providers in Nutley, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; 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.