NPIMap

Organization Active NPI

Philadelphia VA Medical Center

  • VA Clinic/Center
  • Fort Dix, NJ
National Provider Identifier
1114128832
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
License
25MB08244700 Issued in NJ
Legal business name
PHILADELPHIA VA MEDICAL CENTER
Practice address
8TH and Alabama St
Building 5437
Fort Dix, NJ 08640
Phone
(609) 562-2999
NPI assigned
May 30, 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. Michael Gliatto, M.D.
Title
Hiring Officer
Phone
(215) 823-4037

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
VA Clinic/Center 261QV0200X 25MB08244700 NJ Primary

Addresses

Primary practice location

8TH and Alabama St
Building 5437
Fort Dix, NJ 08640

Mailing address

834 Chestnut St
Appartment 732
Philadelphia, PA 19107-5127
Phone (215) 840-4223

National Provider Directory

National Provider Directory
Tax ID family
Philadelphia Vamc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114128832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 CHESTNUT ST",
            "address_2": "APPARTMENT 732",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075127",
            "telephone_number": "215-840-4223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8TH AND ALABAMA ST",
            "address_2": "BUILDING 5437",
            "city": "FORT DIX",
            "state": "NJ",
            "postal_code": "08640",
            "telephone_number": "609-562-2999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILADELPHIA VA MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GLIATTO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "HIRING OFFICER",
        "authorized_official_telephone_number": "215-823-4037",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": "NJ",
            "license": "25MB08244700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Dix, 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.