Black Creek Medical LLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

BLACK CREEK MEDICAL LLC

Practice address

46 N Central Ave
Ramsey, NJ 07446-1864

Phone

(914) 376-6100

Fax

(914) 470-5056

NPI assigned

Oct 26, 2021

Last updated

Oct 26, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Salerno, MD

Title

Owner

Phone

(914) 376-6100

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635206400000",
    "number": "1134883143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 648",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199630648",
            "telephone_number": "914-376-6100",
            "fax_number": "914-470-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 N CENTRAL AVE",
            "city": "RAMSEY",
            "state": "NJ",
            "postal_code": "074461864",
            "telephone_number": "914-376-6100",
            "fax_number": "914-470-5056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK CREEK MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-26",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A",
        "authorized_official_last_name": "SALERNO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "914-376-6100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathania Bernadin, LMT
• Kristine Bersch, LSW
• Cynthia C. Better, MSW LCSW
• Yasmin Bhasin, M.D.
• Justina Mathai Bittman, LAC
• Douglas G Blackmore, D.D.S.
• Bloom Pelvic Health
• Kelly Theresa Boccio, MA, NCC, LAC
• Robert Edward Boff, D.M.D.
• Joshua Boyce, PT

• Vascular Surgery Physician in Ramsey, NJ
• Providers in Ramsey, NJ by specialty
• Vascular Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; 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.