Organization Active NPI

Medicine and Rehabilitation PC

  • Internal Medicine Physician
  • Englewood Cliffs, NJ
National Provider Identifier
1407893662
Registry record updated Jan 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA67595 Issued in NJ
Legal business name
MEDICINE AND REHABILITATION PC
Practice address
333 Sylvan Ave Ste 111
Englewood Cliffs, NJ 07632-2705
Phone
(201) 568-8500
Fax
(201) 568-8518
NPI assigned
May 31, 2006
Last updated
Jan 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2011

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

Authorized official

Name
Andrei Logvinenko, M.D.NPI 1952348195
Title
President
Phone
(201) 568-8500

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA67595 NJ Primary
Physical Medicine & Rehabilitation Physician 208100000X MA63969 NJ

Addresses

Primary practice location

333 Sylvan Ave Ste 111
Englewood Cliffs, NJ 07632-2705

Mailing address

PO Box 37
Franklin Lakes, NJ 07417-0037
Phone (201) 568-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090528000030 NJ Part B Supplier - Clinic/Group Practice 4082763875 Receives reassigned benefits from 1 practitioner
Practice locations: Fair Lawn, NJ; West Orange, NJ

National Provider Directory

National Provider Directory

Locations

14-25 Plaza Rd
#531
Fair Lawn, NJ 07410
Phone (201) 797-2050

14-25 Plaza Rd
Ste S31
Fair Lawn, NJ 07410
Phone (201) 797-2050

Practitioners & affiliated clinicians

Practitioners 6

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": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294876800000",
    "number": "1407893662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37",
            "city": "FRANKLIN LAKES",
            "state": "NJ",
            "postal_code": "074170037",
            "telephone_number": "201-568-8500",
            "fax_number": "201-568-8518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SYLVAN AVE STE 111",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076322705",
            "telephone_number": "201-568-8500",
            "fax_number": "201-568-8518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICINE AND REHABILITATION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2011-01-13",
        "status": "A",
        "authorized_official_last_name": "LOGVINENKO",
        "authorized_official_first_name": "ANDREI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-568-8500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA67595",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "MA63969",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood Cliffs, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.