Itserga Medical LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA07826100 Issued in NJ

Legal business name

ITSERGA MEDICAL LLC

Practice address

181 Franklin Ave
Suite#201
Nutley, NJ 07110-3820

Phone

(973) 284-0777

Fax

(973) 284-1530

NPI assigned

Jun 15, 2010

Organization subpart

No

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

Authorized official

Name

James V Agresti III, MD

Title

President

Phone

(973) 284-0777

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276560000000",
    "number": "1477874352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 FRANKLIN AVE",
            "address_2": "SUITE#201",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071103820",
            "telephone_number": "973-284-0777",
            "fax_number": "973-284-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 FRANKLIN AVE",
            "address_2": "SUITE#201",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071103820",
            "telephone_number": "973-284-0777",
            "fax_number": "973-284-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ITSERGA MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-15",
        "last_updated": "2010-06-15",
        "status": "A",
        "authorized_official_last_name": "AGRESTI",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-284-0777",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA07826100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Nutley, NJ
• Providers in Nutley, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2010; 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.