Active NPI
Optimo Physician Associates
- Internal Medicine Physician
- Sewell, NJ
National Provider Identifier
1619294170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 25MA05828000
- Legal business name
- OPTIMO PHYSICIAN ASSOCIATES
- Practice address
- 438 Ganttown Rd
Suite B-1
Sewell, NJ 08080-2341 - Phone
- (609) 744-4555
- Fax
- (856) 258-4557
- NPI assigned
- Apr 23, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Joseph Anthony Libby, M.D.
- Title
- Owner
- Phone
- (609) 744-4555
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 25MA05828000 | NJ | Primary |
Addresses
Primary practice location
438 Ganttown Rd
Suite B-1
Sewell, NJ 08080-2341
Mailing address
438 Ganttown Rd
Suite B-1
Sewell, NJ 08080-2341
Phone (609) 744-4555
National Provider Directory
National Provider DirectoryLocations
438 Ganttown Rd
Ste B1
Sewell, NJ 08080
Phone (856) 270-2053
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271980800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1374537600000",
"number": "1619294170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "438 GANTTOWN RD",
"address_2": "SUITE B-1",
"city": "SEWELL",
"state": "NJ",
"postal_code": "080802341",
"telephone_number": "609-744-4555",
"fax_number": "856-258-4557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "438 GANTTOWN RD",
"address_2": "SUITE B-1",
"city": "SEWELL",
"state": "NJ",
"postal_code": "080802341",
"telephone_number": "609-744-4555",
"fax_number": "856-258-4557"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OPTIMO PHYSICIAN ASSOCIATES",
"organizational_subpart": "NO",
"enumeration_date": "2010-04-23",
"last_updated": "2013-07-23",
"status": "A",
"authorized_official_last_name": "LIBBY",
"authorized_official_first_name": "JOSEPH",
"authorized_official_middle_name": "ANTHONY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "609-744-4555",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "NJ",
"license": "25MA05828000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sewell, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.