Medical Alliance of New Jersey PC

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

25MA04527600 Issued in NJ

Legal business name

MEDICAL ALLIANCE OF NEW JERSEY PC

Practice address

4806 11TH Ave
Brooklyn, NY 11219-2931

Phone

(347) 988-5822

NPI assigned

Aug 24, 2017

Organization subpart

No

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

Authorized official

Name

Naftali Tyberg

Title

Genarel Manager

Phone

(347) 988-5822

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503532800000",
    "number": "1215454905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4806 11TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4806 11TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192931",
            "telephone_number": "347-988-5822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ALLIANCE OF NEW JERSEY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-24",
        "last_updated": "2017-08-24",
        "status": "A",
        "authorized_official_last_name": "TYBERG",
        "authorized_official_first_name": "NAFTALI",
        "authorized_official_title_or_position": "GENAREL MANAGER",
        "authorized_official_telephone_number": "347-988-5822"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NJ",
            "license": "25MA04527600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.