NJ Med PA

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

25MA05507700 Issued in NJ

Legal business name

NJ MED PA

Practice address

240 Williamson St
Suite 204
Elizabeth, NJ 07202-3674

Phone

(908) 355-8877

NPI assigned

Sep 11, 2014

Organization subpart

Yes

Parent organization

MEDVANTX INC.As reported in NPPES

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

Authorized official

Name

Kenny Heine

Title

VP of Operations

Phone

(858) 964-1506

Specialties & licenses 1

Addresses

Part of

Tri - State Medical Group Inc

Practitioners 3

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

• Taylor Mackenzie Morris, PA-C

  • Medical Physician Assistant
  • Livingston, NJ
  • NPI 1497488183
  NPD
• Michael R Zaboski, M.D.

  • Internal Medicine Physician
  • Elizabeth, NJ
  • NPI 1043302946
  NPD
• William J McHugh, MD

  • Internal Medicine Physician
  • Elizabeth, NJ
  • NPI 1912082660
  NPD (past)

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410393600000",
    "number": "1225439037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 WILLIAMSON ST",
            "address_2": "SUITE 204",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072023674",
            "telephone_number": "908-355-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NJ MED PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX INC.",
        "enumeration_date": "2014-09-11",
        "last_updated": "2014-09-11",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "858-964-1506"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NJ",
            "license": "25MA05507700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Stewart Nieroda, D.C
• Avinash C Nigam, M.D.
• NJ Balance Testing & Fall Prevention Assoc LLC
• NJ Center for Pain & Rehabilitation
• NJ Golden Home Care
• NJ Med, PA
• NJ Pain Management & Rehab, P.a.
• NJ Sunny Home Care Inc
• NJ Urgentcare
• Nna of Elizabeth, L.L.C.

• Non-Pharmacy Dispensing Site in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• Non-Pharmacy Dispensing Site in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2014; 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.