Active NPI
Alexander Antonenko, M.D.
- Family Medicine Physician
- Vineland, NJ
National Provider Identifier
1437312394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 25MA08682600
- Practice address
- 319 Landis Avenue
Vineland, NJ 08360 - Phone
- (856) 451-4700
- Fax
- (856) 451-8685
- NPI assigned
- Jul 9, 2008
- Last updated
- Jul 28, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 25MA08682600 | NJ | Primary |
Addresses
Primary practice location
319 Landis Avenue
Vineland, NJ 08360
Mailing address
53 S. Laurel Street 2ND Floor
Bridgeton, NJ 08302
Phone (856) 451-4700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA08682600 | NJ | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280275200000",
"number": "1437312394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "53 S. LAUREL STREET 2ND FLOOR",
"city": "BRIDGETON",
"state": "NJ",
"postal_code": "08302",
"telephone_number": "856-451-4700",
"fax_number": "856-451-8685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "319 LANDIS AVENUE",
"city": "VINELAND",
"state": "NJ",
"postal_code": "08360",
"telephone_number": "856-451-4700",
"fax_number": "856-451-8685"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTONENKO",
"first_name": "ALEXANDER",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-09",
"last_updated": "2010-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NJ",
"license": "25MA08682600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vineland, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.