Wilbur J Pan, MD

Primary specialty

Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X

License

25MA71532 Issued in NJ

Practice address

195 Little Albany St
The Cancer Institute of New Jersey
New Brunswick, NJ 08901-1914

Phone

(732) 235-6455

Fax

(732) 235-6462

NPI assigned

Oct 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hackensack Meridian Health Medical Group - Complex Care PC

  • Internal Medicine Physician
  • Red Bank, NJ
  • NPI 1154379626
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207872000000",
    "number": "1477637429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 WEST GILBERT ST",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "07701",
            "telephone_number": "732-212-0051",
            "fax_number": "732-212-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 LITTLE ALBANY ST",
            "address_2": "THE CANCER INSTITUTE OF NEW JERSEY",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011914",
            "telephone_number": "732-235-6455",
            "fax_number": "732-235-6462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAN",
        "first_name": "WILBUR",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2008-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "NJ",
            "license": "25MA71532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8379602",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marisa Palmeri, MD
• Hollie Leah Palmisano, LAT, ATC
• Kristy Therese Salisbury Palomares, M.D., PH.D.
• Adare Pampinella, PAC
• Kun Pan, MD
• Casey G Panebianco, NP-C
• Reynold A Panettieri Jr., MD
• Neal Panse, MD
• Enrique J Pantin, MD
• Nicholas Charles Paolino, M.S.

• Pediatric Hematology & Oncology Physician in New Brunswick, NJ
• Providers in New Brunswick, NJ by specialty
• Pediatric Hematology & Oncology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; 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.