Peritonial Dialysis on North America,LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

MA068150 Issued in NJ

Legal business name

PERITONIAL DIALYSIS ON NORTH AMERICA,LLC

Practice address

1030 St.George Ave
Lower Level 1
Avenel, NJ 07001

Phone

(732) 750-5555

Fax

(732) 750-5550

NPI assigned

Jul 7, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Alexander M Swan, M.DNPI 1346218856

Title

Owner

Phone

(732) 750-5555

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alexander M Swan, MD

  • Nephrology Physician
  • Avenel, NJ
  • NPI 1346218856
  NPD (past) Authorized official

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230422400000",
    "number": "1215969563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 ST.GEORGE AVE",
            "address_2": "LOWER LEVEL 1",
            "city": "AVENEL",
            "state": "NJ",
            "postal_code": "07001",
            "telephone_number": "732-750-5555",
            "fax_number": "732-750-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 ST.GEORGE AVE",
            "address_2": "LOWER LEVEL 1",
            "city": "AVENEL",
            "state": "NJ",
            "postal_code": "07001",
            "telephone_number": "732-750-5555",
            "fax_number": "732-750-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERITONIAL DIALYSIS ON NORTH AMERICA,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2008-12-28",
        "status": "A",
        "authorized_official_last_name": "SWAN",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-750-5555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "MA068150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8974004",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nephrology Physician in Avenel, NJ
• Providers in Avenel, NJ by specialty
• Nephrology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2008; 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.