Organization Active NPI

Angeles L Luchayco MD PC

  • Pediatrics Physician
  • Jersey City, NJ
National Provider Identifier
1073665907
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA02984700 Issued in NJ
Legal business name
ANGELES L LUCHAYCO MD PC
Practice address
119 Ocean Avenue
Jersey City, NJ 07305
Phone
(201) 332-6677
Fax
(201) 332-6677
NPI assigned
Jan 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Angeles Lim Luchayco, MD
Title
President
Phone
(201) 332-6677

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 25MA02984700 NJ Primary

Addresses

Primary practice location

119 Ocean Avenue
Jersey City, NJ 07305

Mailing address

119 Ocean Avenue
Jersey City, NJ 07305
Phone (201) 332-6677

Other identifiers 1

IdentifierTypeStateIssuer
1185705MedicaidNJ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073665907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 OCEAN AVENUE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07305",
            "telephone_number": "201-332-6677",
            "fax_number": "201-332-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 OCEAN AVENUE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07305",
            "telephone_number": "201-332-6677",
            "fax_number": "201-332-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELES L LUCHAYCO MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUCHAYCO",
        "authorized_official_first_name": "ANGELES",
        "authorized_official_middle_name": "LIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-332-6677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA02984700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1185705",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.