NPIMap

Organization Active NPI

North Jersey Colon & Rectal Surgical Associates PA

  • Colon & Rectal Surgery Physician
  • Fair Lawn, NJ
National Provider Identifier
1134288152
Registry record updated Sep 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
MA44217 Issued in NJ
Legal business name
NORTH JERSEY COLON & RECTAL SURGICAL ASSOCIATES PA
Practice address
4-14 Saddle River Rd
Fair Lawn, NJ 07410-5632
Phone
(201) 791-4002
Fax
(201) 791-7040
NPI assigned
Dec 6, 2006
Last updated
Sep 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2008

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

Authorized official

Name
Joel S Nizin, M.D.
Title
VP
Phone
(201) 791-4002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X MA44217 NJ Primary

Addresses

Primary practice location

4-14 Saddle River Rd
Fair Lawn, NJ 07410-5632

Mailing address

4-14 Saddle River Rd
Fair Lawn, NJ 07410-5632
Phone (201) 791-4002

Other identifiers 4

IdentifierTypeStateIssuer
1008706MedicaidNJ
7970404MedicaidNJ
0439207MedicaidNJ
0505803MedicaidNJ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221609600000",
    "number": "1134288152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4-14 SADDLE RIVER RD",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074105632",
            "telephone_number": "201-791-4002",
            "fax_number": "201-791-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4-14 SADDLE RIVER RD",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074105632",
            "telephone_number": "201-791-4002",
            "fax_number": "201-791-7040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH JERSEY COLON & RECTAL SURGICAL ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2008-09-17",
        "status": "A",
        "authorized_official_last_name": "NIZIN",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "201-791-4002",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NJ",
            "license": "MA44217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1008706",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7970404",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0439207",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0505803",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; 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.