The Gastroenterology Group of Northern New Jersey,LLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

25MA03997000 Issued in NJ

Legal business name

THE GASTROENTEROLOGY GROUP OF NORTHERN NEW JERSEY,LLC

Practice address

420 Grand Ave
Suite 101
Englewood, NJ 07631-4152

Phone

(201) 569-7044

Fax

(201) 569-1999

NPI assigned

Dec 2, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Ivan A Friedrich, M.D.

Title

Physician/Board of Governors

Phone

(201) 569-7044

Specialties & licenses 1

Addresses

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kyoung Sun Baek, APN RPN

  • Gerontology Nurse Practitioner
  • Englewood Cliffs, NJ
  • NPI 1982159174
  NPD (past)
• Melanie Jordan Burgos, MD

  • Gastroenterology Physician
  • Englewood Cliffs, NJ
  • NPI 1538695531
  NPD (past)
• Danielle Marie Harkin, APN

  • Family Nurse Practitioner
  • Englewood, NJ
  • NPI 1982554879

  Single Specialty

  NPD (past)
• Yoon Hee Kim

  • Acute Care Nurse Practitioner
  • Englewood, NJ
  • NPI 1184470098
  NPD (past)
• Melissa Christine Kirchner, RD

  • Registered Dietitian
  • Brick, NJ
  • NPI 1952944845
  NPD (past)
• Robin E Lynch, RDN

  • Registered Dietitian
  • Manasquan, NJ
  • NPI 1700314523
  NPD (past)
• Tatiana Valderrama, APN-C

  • Nurse Practitioner
  • Newark, NJ
  • NPI 1831423052
  NPD (past)

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

{
    "created_epoch": "1385942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386633600000",
    "number": "1073944005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 GRAND AVE",
            "address_2": "SUITE 101",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "07631",
            "telephone_number": "201-569-7044",
            "fax_number": "201-569-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 GRAND AVE",
            "address_2": "SUITE 101",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314152",
            "telephone_number": "201-569-7044",
            "fax_number": "201-569-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE GASTROENTEROLOGY GROUP OF NORTHERN NEW JERSEY,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-02",
        "last_updated": "2013-12-10",
        "status": "A",
        "authorized_official_last_name": "FRIEDRICH",
        "authorized_official_first_name": "IVAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN/BOARD OF GOVERNORS",
        "authorized_official_telephone_number": "201-569-7044",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "25MA03997000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Englewood, NJ
• Providers in Englewood, NJ by specialty
• Gastroenterology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2013; 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.