Organization Active NPI

PCN Medical Group, LLC

  • Nephrology Physician
  • Montvale, NJ
National Provider Identifier
1063834711
Registry record updated Jan 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
PCN MEDICAL GROUP, LLC
Practice address
221 W Grand Ave
Montvale, NJ 07645-1729
Phone
(201) 746-9333
Fax
(201) 746-9335
NPI assigned
Jan 15, 2014
Last updated
Jan 15, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2014

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

Authorized official

Name
Mrs. Gabriela Wojarnska-Alvarez, MD
Title
Medical Director
Phone
(201) 746-9333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X Primary

Addresses

Primary practice location

221 W Grand Ave
Montvale, NJ 07645-1729

Mailing address

221 W Grand Ave
Montvale, NJ 07645-1729
Phone (201) 746-9333

National Provider Directory

National Provider Directory

Locations

221 W Grand Ave
Montvale, NJ 07645
Phone (201) 307-9209

221 W Grand Ave
Ste 105
Montvale, NJ 07645
Phone (201) 746-9333

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389744000000",
    "number": "1063834711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 W GRAND AVE",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451729",
            "telephone_number": "201-746-9333",
            "fax_number": "201-746-9335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W GRAND AVE",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451729",
            "telephone_number": "201-746-9333",
            "fax_number": "201-746-9335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PCN MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-15",
        "last_updated": "2014-01-15",
        "status": "A",
        "authorized_official_last_name": "WOJARNSKA-ALVAREZ",
        "authorized_official_first_name": "GABRIELA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "201-746-9333",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montvale, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; 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.