Bergen Medical Center Multi Specialty Group, LLC

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

License

MA49009 Issued in NJ

Legal business name

BERGEN MEDICAL CENTER MULTI SPECIALTY GROUP, LLC

Practice address

1 W Ridgewood Ave
G3
Paramus, NJ 07652-2359

Phone

(201) 262-8274

Fax

(201) 262-8718

NPI assigned

May 21, 2007

Organization subpart

No

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

Authorized official

Name

Jeffrey Allen Shanton

Title

Admin

Phone

(201) 262-8274

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447468475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W RIDGEWOOD AVE",
            "address_2": "G3",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076522359",
            "telephone_number": "201-262-8274",
            "fax_number": "201-262-8718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W RIDGEWOOD AVE",
            "address_2": "G3",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076522359",
            "telephone_number": "201-262-8274",
            "fax_number": "201-262-8718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERGEN MEDICAL CENTER MULTI SPECIALTY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHANTON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "201-262-8274"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "NJ",
            "license": "MA49009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bergen Essex Infectious Diseases PA
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• Bergen Hypertension & Renal Assoc
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• Bergen Medical Associates, P.C.
• Bergen Medical Imaging, LLC
• Bergen Medical Sports & Spine, Inc.
• Bergen Open MRI & Diagnostic Imaging Inc
• Bergen Pain Management PC
• Bergen Psychotherapy & Group, P.C.

• Occupational Medicine Physician in Paramus, NJ
• Providers in Paramus, NJ by specialty
• Occupational Medicine Physician in New Jersey

• 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.