Organization Active NPI

Moukdad Medical LLC

  • Internal Medicine Physician
  • North Bergen, NJ
National Provider Identifier
1477430239
Registry record updated May 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MOUKDAD MEDICAL LLC
Practice address
6725 Columbia Ave
North Bergen, NJ 07047-5696
Phone
(201) 691-7234
NPI assigned
Aug 21, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2026

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

Authorized official

Name
Amanda Marchione, DO
Title
Owner
Phone
(201) 422-3111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

6725 Columbia Ave
North Bergen, NJ 07047-5696

Mailing address

6725 Columbia Ave
North Bergen, NJ 07047-5696
Phone (201) 422-3111

Other practice location 1

1265 Paterson Plank Rd Ste 3B
Secaucus, NJ 07094-3242
Phone (201) 223-1121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251126004149 NJ Part B Supplier - Clinic/Group Practice 5193217065 Receives reassigned benefits from 1 practitioner
Practice locations: North Bergen, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1755734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779494400000",
    "number": "1477430239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6725 COLUMBIA AVE",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070475696",
            "telephone_number": "201-422-3111",
            "fax_number": "201-422-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6725 COLUMBIA AVE",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070475696",
            "telephone_number": "201-691-7234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1265 Paterson Plank Rd Ste 3B",
            "address_purpose": "LOCATION",
            "city": "Secaucus",
            "state": "NJ",
            "postal_code": "070943242",
            "country_code": "US",
            "telephone_number": "201-223-1121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOUKDAD MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-21",
        "last_updated": "2026-05-23",
        "certification_date": "2026-05-23",
        "status": "A",
        "authorized_official_last_name": "MARCHIONE",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-422-3111",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bergen, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.