Advanced Gastroenterology of Northern NJ PC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

25MA07335100 Issued in NJ

Legal business name

ADVANCED GASTROENTEROLOGY OF NORTHERN NJ PC

Practice address

521 Route 515
Suites 3 & 4
Vernon, NJ 07462-3033

Phone

(973) 864-6029

Fax

(973) 864-1010

NPI assigned

Jan 28, 2011

Last updated

Mar 25, 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

Eric R Rosendorf, MD

Title

Owner

Phone

(973) 864-6029

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1296172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301011200000",
    "number": "1447556105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SUMMIT AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070432223",
            "telephone_number": "973-864-6029",
            "fax_number": "973-867-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 ROUTE 515",
            "address_2": "SUITES 3 & 4",
            "city": "VERNON",
            "state": "NJ",
            "postal_code": "074623033",
            "telephone_number": "973-864-6029",
            "fax_number": "973-864-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED GASTROENTEROLOGY OF NORTHERN NJ PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-28",
        "last_updated": "2011-03-25",
        "status": "A",
        "authorized_official_last_name": "ROSENDORF",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-864-6029",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "25MA07335100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Vernon, NJ
• Providers in Vernon, NJ by specialty
• Gastroenterology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.