Park Pediatrics, PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA05499700 Issued in NJ

Legal business name

PARK PEDIATRICS, PA

Practice address

443 E Westfield Ave
Roselle Park, NJ 07204-2428

Phone

(908) 245-2442

Fax

(908) 245-6258

NPI assigned

Jun 18, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Emanuel Corbo, M.D.

Title

President

Phone

(908) 245-2442

Specialties & licenses 1

Addresses

Other names 1

• Emanuel Corbo, MD Doing business as

Locations

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1043471402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "443 E WESTFIELD AVE",
            "city": "ROSELLE PARK",
            "state": "NJ",
            "postal_code": "072042428",
            "telephone_number": "908-245-2442",
            "fax_number": "908-245-6258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "443 E WESTFIELD AVE",
            "city": "ROSELLE PARK",
            "state": "NJ",
            "postal_code": "072042428",
            "telephone_number": "908-245-2442",
            "fax_number": "908-245-6258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PEDIATRICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-18",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "CORBO",
        "authorized_official_first_name": "EMANUEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-245-2442",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA05499700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emanuel Corbo, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatrics Physician in Roselle Park, NJ
• Providers in Roselle Park, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.