Endosurgical MD PA

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

25MA45725 Issued in NJ

Legal business name

ENDOSURGICAL MD PA

Practice address

335 Passaic St
Passaic, NJ 07055-5818

Phone

(973) 779-5554

NPI assigned

Mar 9, 2007

Last updated

Feb 4, 2011By 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. Juan De la Cruz, M.D.NPI 1467568311

Title

Medical Director

Phone

(973) 779-5554

Specialties & licenses 2

Addresses

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.

• Juan De la Cruz, M.D.

  • Surgery Physician
  • Vega Baja, PR
  • NPI 1467568311
  NPD Authorized official

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296777600000",
    "number": "1417089335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 VIRVICKAS STREET",
            "city": "WOODLAND PARK",
            "state": "NJ",
            "postal_code": "074240000",
            "telephone_number": "973-779-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 PASSAIC ST",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070555818",
            "telephone_number": "973-779-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOSURGICAL MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2011-02-04",
        "status": "A",
        "authorized_official_last_name": "DE LA CRUZ",
        "authorized_official_first_name": "JUAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "973-779-5554",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA45725",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "NJ",
            "license": "25MA45725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Daniela Encarnacion
• Meir L Epstein
• Tova Erreich, M.A., CCC-SLP
• Alyson Escalona, OD
• Angelica Escribano, LPC
• Jose Espinosa, RD

• General Practice Physician in Passaic, NJ
• Providers in Passaic, NJ by specialty
• General Practice Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.