Clifton Wallington Medical Gropu

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA05999500 Issued in NJ

Legal business name

CLIFTON WALLINGTON MEDICAL GROPU

Practice address

1033 Clifton Ave
Suite 210
Clifton, NJ 07013-3517

Phone

(973) 473-4624

Fax

(973) 476-4547

NPI assigned

Oct 26, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Amy Devirgilio

Title

Billing Mananger

Phone

(973) 473-4624

Specialties & licenses 1

Addresses

Tax ID family

Clifton-Wallington Medical Group3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Clifton-Wallington Medical Group

  • Internal Medicine Physician
  • Clifton, NJ
  • NPI 1548209315
  NPD tax ID
• Clifton-Wallington Medical Group

  • Internal Medicine Physician
  • Wallington, NJ
  • NPI 1568401495
  NPD tax ID

Locations

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124103973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 CLIFTON AVE",
            "address_2": "SUITE 210",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133517",
            "telephone_number": "973-473-4624",
            "fax_number": "973-476-4547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 CLIFTON AVE",
            "address_2": "SUITE 210",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133517",
            "telephone_number": "973-473-4624",
            "fax_number": "973-476-4547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIFTON WALLINGTON MEDICAL GROPU",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEVIRGILIO",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "BILLING MANANGER",
        "authorized_official_telephone_number": "973-473-4624",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA05999500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clifton Spine Sports & Rehabilitation
• Clifton Sports Chiropractic
• Clifton Sports Medicine & Physical Therapy LLC
• Clifton Surgery Center Inc
• Clifton Theraphy and Sports Injury
• Clifton-Wallington Medical Group
• Clinical Wellness
• Donna Marie Cogavin, RPH
• Cohen & Murar Acu
• Rachel Cohen, LCSW

• Specialist in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Specialist in New Jersey

• 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.