MGM Medical Services LLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

MGM MEDICAL SERVICES LLC

Doing business as

MGM Ketamine Center

Practice address

690 Kinderkamack Rd Ste 103
Oradell, NJ 07649-1524

Phone

(201) 267-4785

NPI assigned

Nov 18, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Cheryl Malina, MD

Title

MD

Phone

(646) 345-1998

Specialties & licenses 1

Addresses

Other names 1

• MGM Ketamine Center Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1637193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637193600000",
    "number": "1619634284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 GLENORCHY PL",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108043512",
            "telephone_number": "646-345-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 KINDERKAMACK RD STE 103",
            "city": "ORADELL",
            "state": "NJ",
            "postal_code": "076491524",
            "telephone_number": "201-267-4785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MGM MEDICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-18",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A",
        "authorized_official_last_name": "MALINA",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "646-345-1998",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "fax",
            "affiliation": "N",
            "address_1": "690 Kinderkamack Rd Ste 103",
            "city": "Oradell",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "076491524",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MGM Ketamine Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• MCR Surgical
• James Christopher Mendler, M.D.
• Frances M Merz, MA, LPC
• Bruce L Meyer, O.D.
• MGM Ketamine Services LLC
• Mike Bellamy Counseling LLC
• Monarch Anesthesia of Englewood Cliffs LLC
• Miranda Paige Mondou, CPRS
• Motion Physical Therapy and Wellness
• Nohelia Andreina Munoz Lopez, LMSW

• Emergency Medicine Physician in Oradell, NJ
• Providers in Oradell, NJ by specialty
• Emergency Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; 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.