NPIMap

Organization Active NPI

Midatlantic Diagnostic Services PC

  • Physiological Laboratory
  • Gibbsboro, NJ
National Provider Identifier
1225239262
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
License
DC0006292 Issued in PA
Legal business name
MIDATLANTIC DIAGNOSTIC SERVICES PC
Practice address
55 Pine Rd
Gibbsboro, NJ 08026
Phone
(215) 334-5477
NPI assigned
May 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. James John Demarino, DC
Title
Pres
Phone
(215) 334-5477

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X DC0006292 PA Primary

Addresses

Primary practice location

55 Pine Rd
Gibbsboro, NJ 08026

Mailing address

P. O. Box 152
Cedarbrook, NJ 08018
Phone (215) 334-5477

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225239262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O. BOX 152",
            "city": "CEDARBROOK",
            "state": "NJ",
            "postal_code": "08018",
            "telephone_number": "215-334-5477",
            "fax_number": "215-551-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 PINE RD",
            "city": "GIBBSBORO",
            "state": "NJ",
            "postal_code": "08026",
            "telephone_number": "215-334-5477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDATLANTIC DIAGNOSTIC SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEMARINO",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "215-334-5477",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "PA",
            "license": "DC0006292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gibbsboro, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.