Tri County Medical Associate PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

153068-2 Issued in NY

Legal business name

TRI COUNTY MEDICAL ASSOCIATE PC

Practice address

20 Broadway
Woodridge, NY 12789-0546

Phone

(845) 434-6333

Fax

(845) 434-2346

NPI assigned

Dec 2, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Renu S Jerath, MD

Title

Doctor Owner

Phone

(845) 434-6333

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190937600000",
    "number": "1194709253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 546",
            "address_2": "20 BROADWAY",
            "city": "WOODRIDGE",
            "state": "NY",
            "postal_code": "127890546",
            "telephone_number": "845-434-6333",
            "fax_number": "845-434-2346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 BROADWAY",
            "city": "WOODRIDGE",
            "state": "NY",
            "postal_code": "127890546",
            "telephone_number": "845-434-6333",
            "fax_number": "845-434-2346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI COUNTY MEDICAL ASSOCIATE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-02",
        "last_updated": "2007-09-28",
        "status": "A",
        "authorized_official_last_name": "JERATH",
        "authorized_official_first_name": "RENU",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DOCTOR OWNER",
        "authorized_official_telephone_number": "845-434-6333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "153068-2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabel Martinez
• Kornelia Mierzejewska
• Dorothy Novogrodsky, ED. D. BCBA-D
• Oda Primary Health Care Network, Inc.
• Charles Robinson Jr.
• Allison Wall-Carty, LMHC
• Shayna Sara Raizel Weinberg, CIC-CSP, CD(DONA)
• Mark A York II, LPN

• Family Medicine Physician in Woodridge, NY
• Providers in Woodridge, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2007; 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.