Organization Active NPI

Raymnd Lanza, DO

  • Geriatric Medicine (Internal Medicine) Physician
  • Green Brook, NJ
National Provider Identifier
1093961237
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
25MB03658300 Issued in NJ
Legal business name
RAYMND LANZA, DO
Practice address
21 Fairway Dr
Green Brook, NJ 08812-2064
Phone
(732) 991-5020
NPI assigned
Aug 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Authorized official

Name
Dr. Raymond Lanza, D.O.
Title
Owner
Phone
(732) 991-5020

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X 25MB03658300 NJ Primary
Medical Specialty Clinic/Center 261QM2500X

Addresses

Primary practice location

21 Fairway Dr
Green Brook, NJ 08812-2064

Mailing address

21 Fairway Dr
Green Brook, NJ 08812-2064
Phone (732) 991-5020

Other names 1

  • Raymond Lanza, DO Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address drraylanza@direct.practicefusion.com Health Information Exchange (HIE)
Direct Messaging Address drraylanza@direct.practicefusion.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

853 Park Ave
Elizabeth, NJ 07208
Phone (201) 352-1334

Interoperability endpoints

  • Direct secure messaging: drraylanza@direct.practicefusion.com

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1218067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1093961237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 FAIRWAY DR",
            "city": "GREEN BROOK",
            "state": "NJ",
            "postal_code": "088122064",
            "telephone_number": "732-991-5020",
            "fax_number": "732-399-9784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 FAIRWAY DR",
            "city": "GREEN BROOK",
            "state": "NJ",
            "postal_code": "088122064",
            "telephone_number": "732-991-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAYMND LANZA, DO",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-07",
        "last_updated": "2023-09-14",
        "certification_date": "2021-05-28",
        "status": "A",
        "authorized_official_last_name": "LANZA",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-991-5020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "25MB03658300",
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drraylanza@direct.practicefusion.com",
            "affiliation": "N",
            "endpointDescription": "private email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "440 Lighthouse Way",
            "city": "Sanibel",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339573904",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drraylanza@direct.practicefusion.com",
            "affiliation": "N",
            "endpointDescription": "emr",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "440 Lighthouse Way",
            "city": "Sanibel",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339573904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Raymond Lanza, DO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Green Brook, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; 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.