Trident Healthcare PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

TRIDENT HEALTHCARE PC

Practice address

401 Hamburg Tpke Ste 310
Wayne, NJ 07470-2139

Phone

(551) 305-4595

Fax

(551) 236-2485

NPI assigned

Mar 7, 2023

Last updated

Sep 13, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jungsik YooNPI 1831487180

Title

Owner

Phone

(201) 888-7215

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jungsik Yoo, D.O.

  • Hospitalist Physician
  • Massena, NY
  • NPI 1831487180

  Internal Medicine, NJ

  Medicare reassignment NPD Authorized official
• Zakia Dele Bowen, MD

  • Internal Medicine Physician
  • Newark, NJ
  • NPI 1982973731
  Medicare reassignment NPD

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

{
    "created_epoch": "1678147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694563200000",
    "number": "1326748500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 HAMBURG TPKE STE 310",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702139",
            "telephone_number": "551-305-4595",
            "fax_number": "551-236-2485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HAMBURG TPKE STE 310",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702139",
            "telephone_number": "551-305-4595",
            "fax_number": "551-236-2485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIDENT HEALTHCARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-07",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A",
        "authorized_official_last_name": "YOO",
        "authorized_official_first_name": "JUNGSIK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-888-7215"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tri County Home Care LLC (BrightStar Care of Wayne)
• Tri-State Healthcare Management LLC (Lakeview Rehabilitation and Care Center)
• Tri-State Healthcare Management LLC (Lakeview Rehabilitation And Care Center)
• Nicholas J Tria, DMD
• Patrick Joseph Triano, MS, ATC, LAT
• Trinity Rehab Somerset PA (Trinity Rehab Wayne)
• Kelly Michelle Tripi, DPT
• Mary Barr Tripodi, LCSW
• Arianna Trouwborst, AUD, CCC-A
• Truce Nutrition

• Internal Medicine Physician in Wayne, NJ
• Providers in Wayne, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.