Valley Center for Family Medicine PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MA035277 Issued in NJ

Legal business name

VALLEY CENTER FOR FAMILY MEDICINE PC

Practice address

14 Violet TRL
Lafayette, NJ 07848-2203

Phone

(973) 940-0512

NPI assigned

Jan 22, 2007

Organization subpart

No

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

Authorized official

Name

Susanne Muccino

Title

Office MGR

Phone

(973) 940-0512

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322524800000",
    "number": "1619020518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 VIOLET TRL",
            "city": "LAFAYETTE",
            "state": "NJ",
            "postal_code": "078482203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 VIOLET TRL",
            "city": "LAFAYETTE",
            "state": "NJ",
            "postal_code": "078482203",
            "telephone_number": "973-940-0512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY CENTER FOR FAMILY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2011-11-29",
        "status": "A",
        "authorized_official_last_name": "MUCCINO",
        "authorized_official_first_name": "SUSANNE",
        "authorized_official_title_or_position": "OFFICE MGR",
        "authorized_official_telephone_number": "973-940-0512"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MA035277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1163604",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Takacs
• Michele Takacs, DC
• Dana Taylor
• The Devereux Foundation (Devereux Advanced Behavioral Health)
• Jamie Lynn Torre, OTR/L
• Amanda Ventre, LSW
• Vitality Health Center LLC
• Danielle Anne Vitti
• Roberta Warner, CSW, LNHA
• Jennifer Leigh Waters, OTR/L

• Family Medicine Physician in Lafayette, NJ
• Providers in Lafayette, 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 Nov 29, 2011; 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.