NPIMap

Organization Active NPI

Physicians Health Alliance PA

  • Cardiovascular Disease Physician
  • Wayne, NJ
National Provider Identifier
1528047842
Registry record updated Jan 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
PHYSICIANS HEALTH ALLIANCE PA
Practice address
1777 Hamburg Tpke
Wayne, NJ 07470-5211
Phone
(973) 835-6300
Fax
(973) 835-3761
NPI assigned
Jan 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2009

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

Authorized official

Name
Dr. Michael R. Dara, MD
Title
Secretary/Treasurer
Phone
(973) 835-6300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

1777 Hamburg Tpke
Wayne, NJ 07470-5211

Mailing address

1777 Hamburg Tpke
Suite 102
Wayne, NJ 07470-5211
Phone (973) 831-7455

Other identifiers 1

IdentifierTypeStateIssuer
7726805MedicaidNJ

National Provider Directory

National Provider Directory

Locations

1777 Hamburg Tpke
Ste 102
Wayne, NJ 07470
Phone (201) 831-9222

2025 Hamburg Tpke
Ste P
Wayne, NJ 07470
Phone (973) 839-5070

Practitioners & affiliated clinicians

Practitioners 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232496000000",
    "number": "1528047842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 HAMBURG TPKE",
            "address_2": "SUITE 102",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074705211",
            "telephone_number": "973-831-7455",
            "fax_number": "973-835-3761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 HAMBURG TPKE",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074705211",
            "telephone_number": "973-835-6300",
            "fax_number": "973-835-3761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS HEALTH ALLIANCE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-13",
        "last_updated": "2009-01-21",
        "status": "A",
        "authorized_official_last_name": "DARA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "973-835-6300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7726805",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.