Organization Active NPI

Mendham Medical Group LLP

  • Internal Medicine Physician
  • Mendham, NJ
National Provider Identifier
1366629206
Registry record updated Jan 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MENDHAM MEDICAL GROUP LLP
Practice address
19 E Main St
Mendham, NJ 07945-1503
Phone
(973) 543-6505
Fax
(973) 543-2967
NPI assigned
Jan 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2008

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

Authorized official

Name
Mrs. Judith M Ciuffreda
Title
Office Manager
Phone
(973) 543-6505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

19 E Main St
Mendham, NJ 07945-1503

Mailing address

19 E Main St
Mendham, NJ 07945-1503
Phone (973) 543-6505

Other identifiers 2

IdentifierTypeStateIssuer
2769107MedicaidNJ
41304OtherAETNA

National Provider Directory

National Provider Directory

Locations

19 E Main St
Mendham, NJ 07945
Phone (973) 543-4440

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201046400000",
    "number": "1366629206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 E MAIN ST",
            "city": "MENDHAM",
            "state": "NJ",
            "postal_code": "079451503",
            "telephone_number": "973-543-6505",
            "fax_number": "973-543-2967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 E MAIN ST",
            "city": "MENDHAM",
            "state": "NJ",
            "postal_code": "079451503",
            "telephone_number": "973-543-6505",
            "fax_number": "973-543-2967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENDHAM MEDICAL GROUP LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-23",
        "last_updated": "2008-01-23",
        "status": "A",
        "authorized_official_last_name": "CIUFFREDA",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "973-543-6505",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2769107",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "41304",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mendham, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2008; 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.