Pavonia Gastroenterology LLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

MA05631200 Issued in NJ

Legal business name

PAVONIA GASTROENTEROLOGY LLC

Practice address

600 Pavonia Avenue
3Rd Floor
Jersey City, NJ 07306

Phone

(201) 216-3065

Fax

(201) 499-0250

NPI assigned

May 10, 2007

Organization subpart

No

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

Authorized official

Name

Paul M Stoopack, MD

Title

President

Phone

(201) 216-3065

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508071002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8168 FDR STATION",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10150",
            "telephone_number": "201-216-3065",
            "fax_number": "201-499-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 PAVONIA AVENUE",
            "address_2": "3RD FLOOR",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07306",
            "telephone_number": "201-216-3065",
            "fax_number": "201-499-0250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAVONIA GASTROENTEROLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STOOPACK",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-216-3065",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "MA05631200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5037000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul Weissman P.C.
• Stefan L Paul, DPT
• Pauline Raitses DO PC
• Shawn Paulling
• Pavonia Diagnostic Imaging, PA
• Pavonia Medical Imaging Inc
• Pavonia Optical Inc.
• Pavonia Radiology Center, Inc.
• Peace Care Transportation Inc
• Peace Health Care Services LLC

• Gastroenterology Physician in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Gastroenterology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.