Organization Active NPI

Raffaele Gibilisco,MD,PA

  • Specialist
  • West New York, NJ
National Provider Identifier
1285906552
Registry record updated Jan 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
RAFFAELE GIBILISCO,MD,PA
Practice address
435 59TH St
1St FL
West New York, NJ 07093-2107
Phone
(201) 295-1456
Fax
(201) 295-0266
NPI assigned
Feb 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2013

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

Authorized official

Name
Dr. Raffaele Gibilisco, M.D.
Title
President
Phone
(201) 295-1456

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

435 59TH St
1St FL
West New York, NJ 07093-2107

Mailing address

435 59TH St
1St FL
West New York, NJ 07093-2107
Phone (201) 295-1456

National Provider Directory

National Provider Directory

Locations

7600 River Rd
North Bergen, NJ 07047
Phone (201) 854-5000

435 59th St
West New York, NJ 07093
Phone (201) 295-1456

435 59th St
#1
West New York, NJ 07093
Phone (201) 295-1456

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1328140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358294400000",
    "number": "1285906552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 59TH ST",
            "address_2": "1ST FL",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070932107",
            "telephone_number": "201-295-1456",
            "fax_number": "201-295-0266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 59TH ST",
            "address_2": "1ST FL",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070932107",
            "telephone_number": "201-295-1456",
            "fax_number": "201-295-0266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAFFAELE GIBILISCO,MD,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-02",
        "last_updated": "2013-01-16",
        "status": "A",
        "authorized_official_last_name": "GIBILISCO",
        "authorized_official_first_name": "RAFFAELE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-295-1456",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West New York, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; 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.