Prime Pediatrics PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA06157600 Issued in NJ

Legal business name

PRIME PEDIATRICS PC

Practice address

50 Union Ave
Suite 704
Irvington, NJ 07111-3262

Phone

(973) 373-9600

NPI assigned

May 26, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Fatima Jaffery, MD

Title

Owner

Phone

(973) 373-9600

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266451200000",
    "number": "1316993850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 PARLIN LN",
            "city": "WATCHUNG",
            "state": "NJ",
            "postal_code": "070695419",
            "telephone_number": "973-373-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 UNION AVE",
            "address_2": "SUITE 704",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071113262",
            "telephone_number": "973-373-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME PEDIATRICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2010-02-18",
        "status": "A",
        "authorized_official_last_name": "JAFFERY",
        "authorized_official_first_name": "FATIMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-373-9600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA06157600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9022805",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Irvington, NJ
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; 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.