Care Station Medical Group, PA

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

CARE STATION MEDICAL GROUP, PA

Practice address

456 Prospect Ave
West Orange, NJ 07052-4112

Phone

(973) 731-6767

Fax

(973) 731-9881

NPI assigned

Jun 3, 2010

Organization subpart

No

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

Authorized official

Name

Miranda J Agosto

Title

Billing Manager

Phone

(908) 925-7519

Specialties & licenses 1

Addresses

Other names 1

• Care Station Medical Group Former legal business name

Locations

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490832000000",
    "number": "1194045914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 352",
            "city": "LINDEN",
            "state": "NJ",
            "postal_code": "070360352",
            "telephone_number": "908-925-7519",
            "fax_number": "908-925-2842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 PROSPECT AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524112",
            "telephone_number": "973-731-6767",
            "fax_number": "973-731-9881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARE STATION MEDICAL GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-03",
        "last_updated": "2017-03-30",
        "status": "A",
        "authorized_official_last_name": "AGOSTO",
        "authorized_official_first_name": "MIRANDA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "908-925-7519"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Care Station Medical Group",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• General Practice Physician in West Orange, NJ
• Providers in West Orange, NJ by specialty
• General Practice Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; 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.