NPIMap

Organization Active NPI

Family Medicine Group LLC

  • Family Medicine Physician
  • Bloomingdale, NJ
National Provider Identifier
1376842914
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILY MEDICINE GROUP LLC
Practice address
73 Clark St
Bloomingdale, NJ 07403-1300
Phone
(908) 822-9700
NPI assigned
Mar 22, 2011
Last updated
Mar 22, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2011

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

Authorized official

Name
Dr. Chandra Mangra, MD
Title
MD
Phone
(973) 908-4754

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

73 Clark St
Bloomingdale, NJ 07403-1300

Mailing address

215 W Front St
Suite D
Plainfield, NJ 07060-1166

National Provider Directory

National Provider Directory

Locations

215 W Front St
Ste D
Plainfield, NJ 07060

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300752000000",
    "number": "1376842914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 W FRONT ST",
            "address_2": "SUITE D",
            "city": "PLAINFIELD",
            "state": "NJ",
            "postal_code": "070601166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 CLARK ST",
            "city": "BLOOMINGDALE",
            "state": "NJ",
            "postal_code": "074031300",
            "telephone_number": "908-822-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICINE GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-22",
        "last_updated": "2011-03-22",
        "status": "A",
        "authorized_official_last_name": "MANGRA",
        "authorized_official_first_name": "CHANDRA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "973-908-4754",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomingdale, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; 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.