Active NPI
NJ Medical Practice PC
- Emergency Medicine Physician
- Montclair, NJ
National Provider Identifier
1356798490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- Legal business name
- NJ MEDICAL PRACTICE PC
- Practice address
- 1 Bay Ave
Montclair, NJ 07042-4837 - Phone
- (469) 401-2386
- NPI assigned
- May 18, 2016
- Last updated
- May 18, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Russell Harris, MD
- Title
- Officer
- Phone
- (469) 401-2386
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | Primary | ||
| Physician Assistant | 363A00000X | |||
| Nurse Practitioner | 363L00000X |
Addresses
Primary practice location
1 Bay Ave
Montclair, NJ 07042-4837
Mailing address
13737 Noel Rd
#1600
Dallas, TX 75240-1331
Phone (469) 401-2386
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
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.
-
- Emergency Medicine Physician
- Macungie, PA
- NPI 1598714800
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463529600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1463529600000",
"number": "1356798490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13737 NOEL RD",
"address_2": "#1600",
"city": "DALLAS",
"state": "TX",
"postal_code": "752401331",
"telephone_number": "469-401-2386"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BAY AVE",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070424837",
"telephone_number": "469-401-2386"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NJ MEDICAL PRACTICE PC",
"organizational_subpart": "NO",
"enumeration_date": "2016-05-18",
"last_updated": "2016-05-18",
"status": "A",
"authorized_official_last_name": "HARRIS",
"authorized_official_first_name": "RUSSELL",
"authorized_official_title_or_position": "OFFICER",
"authorized_official_telephone_number": "469-401-2386",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Montclair, NJ
- Next Level Legacy, LLC (Adapt-powered by next level physio)
- Joseph Nicastro, LMT
- Nicholas a. Cannarozzi, M.D., P.a.
- Nicole Garcia PHD LLC (Evolve Psychological Services)
- Cornelius Ioan Nicoll, M.D.
- Collins Chibuzo Njoku, MD
- Wangui N Njoroge, OTR
- No More Thunder ABA
- Pamela Marie Noblin, LCSW
- Noel C Nowicki MD PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.