Hawthorne Pediatrics, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

25MA09694700 Issued in NJ

Legal business name

HAWTHORNE PEDIATRICS, LLC

Practice address

330 Lafayette Ave
Hawthorne, NJ 07506-2506

Phone

(973) 841-5112

Fax

(973) 826-5064

NPI assigned

Aug 3, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Maria Jose Vasena Marengo, M.D.

Title

Owner

Phone

(973) 841-5112

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Claudia Kim, MD

  • Pediatrics Physician
  • Hawthorne, NJ
  • NPI 1023205135
  NPD (past)

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

{
    "created_epoch": "1438560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438732800000",
    "number": "1336525260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 LAFAYETTE AVE",
            "city": "HAWTHORNE",
            "state": "NJ",
            "postal_code": "075062506",
            "telephone_number": "973-841-5112",
            "fax_number": "973-826-5064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 LAFAYETTE AVE",
            "city": "HAWTHORNE",
            "state": "NJ",
            "postal_code": "075062506",
            "telephone_number": "973-841-5112",
            "fax_number": "973-826-5064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAWTHORNE PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-03",
        "last_updated": "2015-08-05",
        "status": "A",
        "authorized_official_last_name": "VASENA MARENGO",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "JOSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-841-5112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NJ",
            "license": "25MA09694700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hawthorne Family Dentistry
• Hawthorne Family Practice
• Hawthorne Integrated Medicine, LLC
• Hawthorne Pain & Spine Center
• Hawthorne Pediatric Therapy, LLC
• Hawthorne Sports and Spine
• Dana Heinold, M.S., CCC-SLP
• Erika Hernandez
• Stephanie Sharon Hernandez, LCSW
• Heather Hill, PT

• Clinic/Center in Hawthorne, NJ
• Providers in Hawthorne, NJ by specialty
• Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.