Nbimc Trinitas Pediatric Medical Group

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

NBIMC TRINITAS PEDIATRIC MEDICAL GROUP

Practice address

225 Williamson St
Elizabeth, NJ 07202-3625

Phone

(908) 994-5452

Fax

(908) 351-7930

NPI assigned

May 4, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Anthony Esposito

Title

Director

Phone

(732) 557-7160

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa Maria Russo, RD

  • Pediatric Nutrition Registered Dietitian
  • Elizabeth, NJ
  • NPI 1831245687
  NPD (past)
• Kyon A Hood, MD

  • Pediatrics Physician
  • Fredericksburg, VA
  • NPI 1134208226

  Pediatrics

  NPD (past)
• Yelena Samofalov, M.D.

  • Pediatrics Physician
  • Southbridge, MA
  • NPI 1780798686

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144288366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15314",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071925314",
            "telephone_number": "732-557-7160",
            "fax_number": "732-557-7109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 WILLIAMSON ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072023625",
            "telephone_number": "908-994-5452",
            "fax_number": "908-351-7930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NBIMC TRINITAS PEDIATRIC MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ESPOSITO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "732-557-7160",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0068071",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Navarro
• Valery Naymagon, OPHTHALMIC DISPENSER
• Wesner Nazaire
• Nazco Optical LLC
• Nazco Optical, LLC
• NDH RX Inc
• NDH RX Inc
• Maureen Ndu, PMHNP
• Neighborhood Health Services Corporation
• Neighbours-Inc

• All providers in Elizabeth, NJ
• Pediatrics Physician 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.