Active NPI
Bladimir Tiburcio
- Vascular Specialist/Technologist Cardiovascular
- Newark, NJ
National Provider Identifier
1205224722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Specialist/Technologist Cardiovascular
- License
- 20130004
- Practice address
- 91 Halsey St Apt 401
Newark, NJ 07102-3086 - Phone
- (973) 234-6550
- NPI assigned
- Jan 6, 2015
- Last updated
- Jan 6, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Specialist/Technologist Cardiovascular | 246XC2903X | 20130004 | NJ | Primary |
Addresses
Primary practice location
91 Halsey St Apt 401
Newark, NJ 07102-3086
Mailing address
91 Halsey St Apt 401
Newark, NJ 07102-3086
Phone (973) 234-6550
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20130004 | NJ | MD | Vascular Specialist/Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1420502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420502400000",
"number": "1205224722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91 HALSEY ST APT 401",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071023086",
"telephone_number": "973-234-6550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "91 HALSEY ST APT 401",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071023086",
"telephone_number": "973-234-6550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIBURCIO",
"first_name": "BLADIMIR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-01-06",
"last_updated": "2015-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "246XC2903X",
"taxonomy_group": "",
"desc": "Specialist/Technologist Cardiovascular, Vascular Specialist",
"state": "NJ",
"license": "20130004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.