Ventnor Physical Medicine, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA70714 Issued in NJ

Legal business name

VENTNOR PHYSICAL MEDICINE, LLC

Practice address

2106 New Road
Suite E-3
Linwood, NJ 08221-1052

Phone

(609) 927-3355

Fax

(609) 927-3385

NPI assigned

Jun 4, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Judi L. Tassone, M.D.

Title

MD

Phone

(609) 927-3355

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184198400000",
    "number": "1457553133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 NEW ROAD",
            "address_2": "SUITE E-3",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "082211052",
            "telephone_number": "609-927-3355",
            "fax_number": "609-927-3385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 NEW ROAD",
            "address_2": "SUITE E-3",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "082211052",
            "telephone_number": "609-927-3355",
            "fax_number": "609-927-3385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VENTNOR PHYSICAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2007-07-12",
        "status": "A",
        "authorized_official_last_name": "TASSONE",
        "authorized_official_first_name": "JUDI",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "609-927-3355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA70714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8348804",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Linwood, NJ
• Providers in Linwood, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; 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.