Kendall Park Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MA04235300 Issued in NJ

Legal business name

KENDALL PARK MEDICAL GROUP

Practice address

3 Stanworth Rd # a
Kendall Park, NJ 08824-1003

Phone

(732) 940-0505

Fax

(732) 940-1997

NPI assigned

Jul 29, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Jaime F Lara, M.D.

Title

Physician

Phone

(732) 940-0505

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1248825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248825600000",
    "number": "1477784155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 STANWORTH RD # A",
            "city": "KENDALL PARK",
            "state": "NJ",
            "postal_code": "088241003",
            "telephone_number": "732-940-0505",
            "fax_number": "732-940-1997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 STANWORTH RD # A",
            "city": "KENDALL PARK",
            "state": "NJ",
            "postal_code": "088241003",
            "telephone_number": "732-940-0505",
            "fax_number": "732-940-1997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENDALL PARK MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-29",
        "last_updated": "2009-07-29",
        "status": "A",
        "authorized_official_last_name": "LARA",
        "authorized_official_first_name": "JAIME",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "732-940-0505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA04235300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rizwanur Kaleel, PA-C
• Nuzhat Karim, M.D.
• Ronald Keith Katz, DDS
• Gregory A Kaufmann, M.D.
• Kendall Park First Aid & Rescue Squad, Inc.
• Hemant H. Kesarwala, M.D.
• Lakshmi Kesarwala, M.D.
• Kids Koncept Pediatrics
• Eugene J Kim, M.D.
• Mary T. Kitazono Hammell, MD

• Family Medicine Physician in Kendall Park, NJ
• Providers in Kendall Park, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2009; 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.