NPIMap

Organization Active NPI

Internal Medicine and Geriatrics Practice, Inc

  • Primary Care Clinic/Center
  • Clifton, NJ
National Provider Identifier
1598803264
Registry record updated Aug 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
MA07809300 Issued in NJ
Legal business name
INTERNAL MEDICINE AND GERIATRICS PRACTICE, INC
Practice address
1414 Main Ave
Suite B
Clifton, NJ 07011-2157
Phone
(973) 253-6000
Fax
(973) 253-6009
NPI assigned
Feb 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2010

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

Authorized official

Name
Dr. Waleed S Lashin, MDNPI 1477590644
Title
President
Phone
(973) 253-6000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X MA07809300 NJ Primary

Addresses

Primary practice location

1414 Main Ave
Suite B
Clifton, NJ 07011-2157

Mailing address

1414 Main Ave
Suite B
Clifton, NJ 07011-2157
Phone (973) 253-6000

Other identifiers 1

IdentifierTypeStateIssuer
0064394MedicaidNJ

Other names 1

  • IM&GP Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070206000577 NJ Part B Supplier - Clinic/Group Practice 5597767426 Receives reassigned benefits from 10 practitioners
Practice locations: Clifton, NJ

National Provider Directory

National Provider Directory

Locations

1414 Main Ave
Ste B
Clifton, NJ 07011
Phone (973) 253-6000

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282780800000",
    "number": "1598803264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 MAIN AVE",
            "address_2": "SUITE B",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070112157",
            "telephone_number": "973-253-6000",
            "fax_number": "973-253-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 MAIN AVE",
            "address_2": "SUITE B",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070112157",
            "telephone_number": "973-253-6000",
            "fax_number": "973-253-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE AND GERIATRICS PRACTICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2010-08-26",
        "status": "A",
        "authorized_official_last_name": "LASHIN",
        "authorized_official_first_name": "WALEED",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-253-6000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NJ",
            "license": "MA07809300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0064394",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IM&GP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.