Bayonne Pediatric Therapy Center LLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

46TR00070400 Issued in NJ

Legal business name

BAYONNE PEDIATRIC THERAPY CENTER LLC

Practice address

252 Broadway
Bayonne, NJ 07002-2522

Phone

(201) 436-0014

Fax

(201) 436-0019

NPI assigned

Apr 29, 2009

Last updated

Apr 29, 2009By 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

Dr. Kris Mammas, DVM

Title

President

Phone

(201) 436-0014

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.

• William Pakos, OTR

  • Occupational Therapist
  • Bayonne, NJ
  • NPI 1346484755
  NPD (past)

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

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240963200000",
    "number": "1033353438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070022522",
            "telephone_number": "201-436-0014",
            "fax_number": "201-436-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070022522",
            "telephone_number": "201-436-0014",
            "fax_number": "201-436-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYONNE PEDIATRIC THERAPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-29",
        "last_updated": "2009-04-29",
        "status": "A",
        "authorized_official_last_name": "MAMMAS",
        "authorized_official_first_name": "KRIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-436-0014",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DVM"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "NJ",
            "license": "46TR00070400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bayonne Medical Center
• Bayonne Medical Plaza, LLC (Integrated Medical Center)
• Bayonne Ortho Fitting LLC (Bayonne Medical supply)
• Bayonne Pain Management Center, LLC
• Bayonne Pediatric Practice
• Bayonne Pharmacy Group LLC (Broadway Care Pharmacy)
• Bayonne Pharmacy Inc
• Bayonne Pharmacy Inc (Jerrys Drug & Surgical Supply)
• Bayonne Podiatry Group
• Bayonne Radonc Associates, LLC

• Point of Service in Bayonne, NJ
• Providers in Bayonne, NJ by specialty
• Point of Service in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2009; 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.