NPIMap

Organization Active NPI

Galloway Pediatrics, LLC

  • Point of Service
  • Galloway, NJ
National Provider Identifier
1447675186
Registry record updated Mar 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
25MA07514000 Issued in NJ
Legal business name
GALLOWAY PEDIATRICS, LLC
Practice address
53 W White Horse Pike Ste D
Galloway, NJ 08205-9450
Phone
(609) 748-2800
Fax
(609) 748-6721
NPI assigned
Mar 4, 2014
Last updated
Mar 4, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2014

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

Authorized official

Name
Edwin Lopez-Bernard, MDNPI 1730147901
Title
Physician-Pediatrics
Phone
(609) 748-2800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X 25MA07514000 NJ Primary

Addresses

Primary practice location

53 W White Horse Pike Ste D
Galloway, NJ 08205-9450

Mailing address

53 W White Horse Pike Ste D
Galloway, NJ 08205-9450
Phone (609) 748-2800

Other identifiers 1

IdentifierTypeStateIssuer
0081175MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Galloway Pediatrics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

53 W White Horse Pike
Ste D
Galloway, NJ 08205
Phone (609) 748-2800

Practitioners & affiliated clinicians

Practitioners 2

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": "1393891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393891200000",
    "number": "1447675186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 W WHITE HORSE PIKE STE D",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059450",
            "telephone_number": "609-748-2800",
            "fax_number": "609-748-6721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 W WHITE HORSE PIKE STE D",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059450",
            "telephone_number": "609-748-2800",
            "fax_number": "609-748-6721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALLOWAY PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-04",
        "last_updated": "2014-03-04",
        "status": "A",
        "authorized_official_last_name": "LOPEZ-BERNARD",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_title_or_position": "PHYSICIAN-PEDIATRICS",
        "authorized_official_telephone_number": "609-748-2800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "NJ",
            "license": "25MA07514000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0081175",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galloway, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; 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.