Edison Family Practice

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MA45007 Issued in NJ

Legal business name

EDISON FAMILY PRACTICE

Practice address

616 Grove Ave
Edison, NJ 08820-3212

Phone

(732) 548-6303

Fax

(732) 549-4676

NPI assigned

Oct 26, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Maria S Flores Dieppa, MD

Title

Owner

Phone

(732) 548-6303

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Edison Family Practice PC Doing business as

Locations

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

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326240000000",
    "number": "1548546286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 GROVE AVE",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203212",
            "telephone_number": "732-548-6303",
            "fax_number": "732-549-4676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 GROVE AVE",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203212",
            "telephone_number": "732-548-6303",
            "fax_number": "732-549-4676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDISON FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-26",
        "last_updated": "2012-01-11",
        "status": "A",
        "authorized_official_last_name": "FLORES DIEPPA",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-548-6303",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MA45007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25MAO4500700ANI",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edison Family Practice PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Edison, NJ
• Providers in Edison, 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 Jan 11, 2012; 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.