Alexis Sorazon MD & Ramon Sandoval MD Great Falls Medical Center

Key facts

NPI: 1154377877
Entity type: Organization (NPI type 2)
Primary specialty: Specialist 174400000X
License: MA63961 (NJ)
Legal business name: ALEXIS SORAZON MD & RAMON SANDOVAL MD GREAT FALLS MEDICAL CENTER
Practice address: 355 Totowa Ave
Paterson, NJ 07502-2125
Phone: (973) 389-1300
NPI assigned: May 25, 2006
Organization subpart: No

Authorized official

Name: Dr. Alexis Corazon, MD
Title: Owner
Phone: (973) 389-1300

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Specialist Group: 193400000X SINGLE SPECIALTY GROUP	174400000X	MA63961	NJ	Yes

Addresses

Primary practice location

355 Totowa Ave
Paterson, NJ 07502-2125

Mailing address

355 Totowa Ave
Paterson, NJ 07502-2125
Phone (973) 389-1300

Other identifiers

Identifier	Type	State	Issuer
7232900	Medicaid	NJ

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 27, 2008.

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1154377877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 TOTOWA AVE",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075022125",
            "telephone_number": "973-389-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 TOTOWA AVE",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075022125",
            "telephone_number": "973-389-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEXIS SORAZON MD & RAMON SANDOVAL MD GREAT FALLS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "CORAZON",
        "authorized_official_first_name": "ALEXIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-389-1300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA63961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7232900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

All providers in Paterson, NJ · Specialist in New Jersey

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2008. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.