Closter Medical Group, PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

CLOSTER MEDICAL GROUP, PA

Practice address

200 Closter Dock Rd
Closter, NJ 07624-1928

Phone

(201) 768-3900

Fax

(201) 768-3840

NPI assigned

May 3, 2007

Last updated

Aug 2, 2010By 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

Ms. Valure Churchill

Title

Office Manager

Phone

(201) 768-3900

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280707200000",
    "number": "1063634459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CLOSTER DOCK RD",
            "city": "CLOSTER",
            "state": "NJ",
            "postal_code": "076241928",
            "telephone_number": "201-768-3900",
            "fax_number": "201-768-3840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CLOSTER DOCK RD",
            "city": "CLOSTER",
            "state": "NJ",
            "postal_code": "076241928",
            "telephone_number": "201-768-3900",
            "fax_number": "201-768-3840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLOSTER MEDICAL GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2010-08-02",
        "status": "A",
        "authorized_official_last_name": "CHURCHILL",
        "authorized_official_first_name": "VALURE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "201-768-3900",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7261403",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dennis Chintala, DC
• Sungah Choi
• Closter Dental PC
• Closter Eye Care, Inc.
• Closter Internal Medicine, P.C.
• Closter Pharmacy Inc (Closter Pharmacy)
• CNC Chiropractic P.C
• Diane Cohen
• Vanessa Coppola, APN
• Cor Group

• Primary Care Clinic/Center in Closter, NJ
• Providers in Closter, NJ by specialty
• Primary Care Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2010; 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.