Organization Active NPI

Northern Valley Vascular Associates

  • Vascular Surgery Physician
  • Old Tappan, NJ
National Provider Identifier
1124035217
Registry record updated Feb 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
210651 Issued in NY
Legal business name
NORTHERN VALLEY VASCULAR ASSOCIATES
Practice address
48 Bi State PLZ # 225
Old Tappan, NJ 07675-7003
Phone
(212) 254-6882
Fax
(212) 254-6886
NPI assigned
Aug 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2017

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

Authorized official

Name
Dr. Matthew Martin Nalbandian, M.D.
Title
Managing Member
Phone
(212) 254-6882

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X 210651 NY Primary

Addresses

Primary practice location

48 Bi State PLZ # 225
Old Tappan, NJ 07675-7003

Mailing address

48 Bi State PLZ # 225
Old Tappan, NJ 07675-7003
Phone (212) 254-6882

National Provider Directory

National Provider Directory

Locations

48 Bi State Plz
#225
Old Tappan, NJ 07675
Phone (212) 254-6882

247 3rd Ave
Rm L1
New York, NY 10010
Phone (212) 253-2608

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": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486080000000",
    "number": "1124035217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 BI STATE PLZ # 225",
            "city": "OLD TAPPAN",
            "state": "NJ",
            "postal_code": "076757003",
            "telephone_number": "212-254-6882",
            "fax_number": "212-254-6886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 BI STATE PLZ # 225",
            "city": "OLD TAPPAN",
            "state": "NJ",
            "postal_code": "076757003",
            "telephone_number": "212-254-6882",
            "fax_number": "212-254-6886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN VALLEY VASCULAR ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2017-02-03",
        "status": "A",
        "authorized_official_last_name": "NALBANDIAN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "212-254-6882",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "210651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Tappan, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2017; 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.