Pediatric Intensive Care Associates, LLC

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

Legal business name

PEDIATRIC INTENSIVE CARE ASSOCIATES, LLC

Practice address

30 Prospect Ave
Hackensack, NJ 07601-1914

Phone

(201) 996-5303

Fax

(201) 996-0754

NPI assigned

May 18, 2007

Last updated

Aug 22, 2020By 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

Dr. Bruce Friedman, MDNPI 1457480113

Title

President

Phone

(201) 996-5303

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Bruce Ira Friedman, MD

  • Pediatric Critical Care Medicine Physician
  • Hackensack, NJ
  • NPI 1457480113
  NPD (past) Authorized official

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346458007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 LEE RD",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070394134",
            "telephone_number": "201-996-5303",
            "fax_number": "201-996-0754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011914",
            "telephone_number": "201-996-5303",
            "fax_number": "201-996-0754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC INTENSIVE CARE ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FRIEDMAN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-996-5303",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Elaine Peguero, LCADC

• Pediatric Critical Care Medicine Physician in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Pediatric Critical Care Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.