St. Anthony Medical Lab

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

ST. ANTHONY MEDICAL LAB

Practice address

654 Avenue C
Suite 303
Bayonne, NJ 07002-3899

Phone

(201) 436-0033

Fax

(201) 436-0079

NPI assigned

Aug 17, 2016

Organization subpart

No

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

Authorized official

Name

Joseph Ibrahim, MDNPI 1225068281

Title

Owner

Phone

(201) 779-3320

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joseph G.a. Ibrahim, M.D.

  • Specialist
  • Bayonne, NJ
  • NPI 1225068281
  NPD Authorized official

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

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471392000000",
    "number": "1619422862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 AVENUE C",
            "address_2": "SUITE 303",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023899",
            "telephone_number": "201-436-0033",
            "fax_number": "201-436-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 AVENUE C",
            "address_2": "SUITE 303",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023899",
            "telephone_number": "201-436-0033",
            "fax_number": "201-436-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. ANTHONY MEDICAL LAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-17",
        "last_updated": "2016-08-17",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-779-3320",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Bayonne, NJ
• Providers in Bayonne, NJ by specialty
• Clinical Medical Laboratory in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.