J. G. Moreno, MD, LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

25MA03554300 Issued in NJ

Legal business name

J. G. MORENO, MD, LLC

Practice address

205 Ridgedale Ave
Florham Park, NJ 07932-1349

Phone

(973) 966-0072

Fax

(908) 879-5009

NPI assigned

Dec 15, 2009

Last updated

Dec 15, 2009By 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. Jose G Moreno, M.D.NPI 1487726386

Title

Owner

Phone

(973) 966-0072

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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.

• Jose G. Moreno, M.D.

  • Psychiatry Physician
  • Florham Park, NJ
  • NPI 1487726386
  Authorized official Same address or phone

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

{
    "created_epoch": "1260835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260835200000",
    "number": "1366771735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 RIDGEDALE AVE",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079321349",
            "telephone_number": "973-966-0072",
            "fax_number": "908-879-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 RIDGEDALE AVE",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079321349",
            "telephone_number": "973-966-0072",
            "fax_number": "908-879-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. G. MORENO, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-15",
        "last_updated": "2009-12-15",
        "status": "A",
        "authorized_official_last_name": "MORENO",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-966-0072",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA03554300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3449807",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "461207",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Integrated Paincare Center LLP
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• Ethan Isidro, MD
• Maksim Ivanouski
• Hariharan Venkatachalam Iyer, M.D.
• Gregg Andrew Jacob, D.M.D.
• Julie Jacob, APN
• Karen Sarah Jacob, LCSW
• Jennifer May Jacobs, M.S. CCC-SLP
• Lili Rachel Jacobson, LPC

• Psychiatry Physician in Florham Park, NJ
• Providers in Florham Park, NJ by specialty
• Psychiatry Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; 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.