Vip Medical Group of NJ, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

VIP MEDICAL GROUP OF NJ, LLC

Practice address

342 Hamburg Tpke Ste 203
Wayne, NJ 07470-2166

Phone

(347) 405-8160

Fax

(347) 405-8161

NPI assigned

Jul 30, 2018

Last updated

Jul 30, 2018By 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

Michael Nguyen, MD

Title

Owner-Authorized Official

Phone

(212) 518-7874

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532908800000",
    "number": "1144708538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 PARK AVE",
            "address_2": "SUITE#1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163486",
            "telephone_number": "212-518-7874",
            "fax_number": "347-405-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 HAMBURG TPKE STE 203",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702166",
            "telephone_number": "347-405-8160",
            "fax_number": "347-405-8161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIP MEDICAL GROUP OF NJ, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-30",
        "last_updated": "2018-07-30",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER-AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "212-518-7874",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "25MA10140500",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2018; 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.