Montclair Medical Associates LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MB08472400 Issued in NJ

Legal business name

MONTCLAIR MEDICAL ASSOCIATES LLC

Practice address

290 S Livingston Ave
Livingston, NJ 07039-3931

Phone

(972) 592-2733

NPI assigned

Oct 25, 2017

Organization subpart

No

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

Authorized official

Name

Renita Oglesby, DO

Title

Owner

Phone

(973) 592-2733

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508889600000",
    "number": "1588176929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 S LIVINGSTON AVE",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070393931",
            "telephone_number": "972-592-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 S LIVINGSTON AVE",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070393931",
            "telephone_number": "972-592-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTCLAIR MEDICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-25",
        "last_updated": "2017-10-25",
        "status": "A",
        "authorized_official_last_name": "OGLESBY",
        "authorized_official_first_name": "RENITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-592-2733",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB08472400",
            "primary": true
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane Mone, APN, FNP-BC
• Jessica Mongare
• Rita Doreen Monks, RN,MSN,APN-BC (NP)
• Yolanda Monroe
• Jill Montag, MS RD
• Mariel Brooks Montgomery, LSW
• Deann Moore, M.D.
• Maria Karissa Parrera Moos, DNP, APN, NP-C, RN-B
• More MD LLC
• Felixberto L Moreno, PTA

• Family Medicine Physician in Livingston, NJ
• Providers in Livingston, 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 Oct 25, 2017; 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.