Genesis Medical Group, LLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

GENESIS MEDICAL GROUP, LLC

Practice address

464 Hudson Ter
Suite 203
Englewood Cliffs, NJ 07632-2902

Phone

(201) 567-7725

Fax

(201) 567-5255

NPI assigned

Jan 7, 2008

Organization subpart

No

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

Authorized official

Name

Katherine Kang, M.D.

Title

President

Phone

(201) 567-7725

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199664000000",
    "number": "1316122559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "464 HUDSON TER",
            "address_2": "SUITE 203",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076322902",
            "telephone_number": "201-567-7725",
            "fax_number": "201-567-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 HUDSON TER",
            "address_2": "SUITE 203",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076322902",
            "telephone_number": "201-567-7725",
            "fax_number": "201-567-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-07",
        "last_updated": "2008-01-07",
        "status": "A",
        "authorized_official_last_name": "KANG",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-567-7725",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.