NPIMap

Organization Active NPI

MGM Medic PC

  • Family Medicine Physician
  • Morris Plains, NJ
National Provider Identifier
1467782904
Registry record updated May 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA087883900 Issued in NJ
Legal business name
MGM MEDIC PC
Doing business as
MGM MEDIC, PC
Practice address
3215 Gates CT
Morris Plains, NJ 07950-3475
Phone
(203) 524-5566
NPI assigned
Jan 6, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2011

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

Authorized official

Name
Bassem G Hanna, MD
Title
Director
Phone
(203) 524-5566

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 25MA087883900 NJ Primary

Addresses

Primary practice location

3215 Gates CT
Morris Plains, NJ 07950-3475

Mailing address

3215 Gates CT
Morris Plains, NJ 07950-3475
Phone (203) 524-5566

Other names 1

  • MGM MEDIC, PC Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1262736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306454400000",
    "number": "1467782904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3215 GATES CT",
            "city": "MORRIS PLAINS",
            "state": "NJ",
            "postal_code": "079503475",
            "telephone_number": "203-524-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 GATES CT",
            "city": "MORRIS PLAINS",
            "state": "NJ",
            "postal_code": "079503475",
            "telephone_number": "203-524-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MGM MEDIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-06",
        "last_updated": "2011-05-27",
        "status": "A",
        "authorized_official_last_name": "HANNA",
        "authorized_official_first_name": "BASSEM",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "203-524-5566",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA087883900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MGM MEDIC, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Morris Plains, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.