Old Bergen Pediatrics PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA06888600 Issued in NJ

Legal business name

OLD BERGEN PEDIATRICS PA

Practice address

4 Highland Ave
Jersey City, NJ 07306-4510

Phone

(201) 434-3997

Fax

(201) 434-3304

NPI assigned

Jul 17, 2009

Last updated

Jul 17, 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. Eduardo Mangosing, M.D.

Title

President

Phone

(201) 434-3997

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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.

• Nelo Dimaculangan, M.D.

  • Pediatrics Physician
  • Jersey City, NJ
  • NPI 1164492971
  NPD

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

{
    "created_epoch": "1247788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247788800000",
    "number": "1053541599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 HIGHLAND AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073064510",
            "telephone_number": "201-434-3997",
            "fax_number": "201-434-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 HIGHLAND AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073064510",
            "telephone_number": "201-434-3997",
            "fax_number": "201-434-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD BERGEN PEDIATRICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-17",
        "last_updated": "2009-07-17",
        "status": "A",
        "authorized_official_last_name": "MANGOSING",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-434-3997",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA06888600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liliko Ogasawara, LCADC,PC
• Uchechi Ogbonnaya
• Jacqueline B Okemwa, NURSE PRACTITIONER
• Mandy Okongo
• Abisoye Oladejo
• Vera Oleynik
• Juan Carlos Oliveros
• Laurence M Oliviero, D.C.
• Ufuoma Isioma Olori, M.D.
• Titilola Olayemi Oloyede, FNP-BC

• Pediatrics Physician in Jersey City, NJ
• Providers in Jersey City, 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 Jul 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.