NPIMap

Organization Active NPI

Main Street Medical Center, PC

  • Internist Chiropractor
  • Milltown, NJ
National Provider Identifier
1407807787
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internist ChiropractorTaxonomy code 111NI0900X
License
25MA03262900 Issued in NJ
Legal business name
MAIN STREET MEDICAL CENTER, PC
Practice address
186 N Main St
Suite a
Milltown, NJ 08850-1418
Phone
(732) 418-0004
Fax
(732) 545-1185
NPI assigned
May 12, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Bonito Y Sanchez, MDNPI 1841202181
Title
Medical Director
Phone
(732) 418-0004

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internist Chiropractor 111NI0900X 25MA03262900 NJ Primary

Addresses

Primary practice location

186 N Main St
Suite a
Milltown, NJ 08850-1418

Mailing address

186 N Main St
Suite a
Milltown, NJ 08850-1418
Phone (732) 418-0004

National Provider Directory

National Provider Directory

Locations

186 N Main St
Ste A
Milltown, NJ 08850
Phone (732) 418-0004

Practitioners & affiliated clinicians

Practitioners 8

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": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407807787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 N MAIN ST",
            "address_2": "SUITE A",
            "city": "MILLTOWN",
            "state": "NJ",
            "postal_code": "088501418",
            "telephone_number": "732-418-0004",
            "fax_number": "732-545-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 N MAIN ST",
            "address_2": "SUITE A",
            "city": "MILLTOWN",
            "state": "NJ",
            "postal_code": "088501418",
            "telephone_number": "732-418-0004",
            "fax_number": "732-545-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET MEDICAL CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SANCHEZ",
        "authorized_official_first_name": "BONITO",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "732-418-0004",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111NI0900X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Internist",
            "state": "NJ",
            "license": "25MA03262900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milltown, NJ

Sources for this page

  • 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.