Internal Medicine Associates of Bergen County P.C

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

25MA07441900 Issued in NJ

Legal business name

INTERNAL MEDICINE ASSOCIATES OF BERGEN COUNTY P.C

Practice address

15 Anderson St
Hackensack, NJ 07601-4508

Phone

(201) 487-3355

Fax

(201) 487-0960

NPI assigned

Apr 10, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Tammy Lynn Miller

Title

Practice Administrator

Phone

(201) 487-3355

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1639342686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 ANDERSON ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076014508",
            "telephone_number": "201-487-3355",
            "fax_number": "201-487-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 ANDERSON ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076014508",
            "telephone_number": "201-487-3355",
            "fax_number": "201-487-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE ASSOCIATES OF BERGEN COUNTY P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-10",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "201-487-3355",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "25MA07441900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER #",
            "identifier": "527229",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Medicine (Internal Medicine) Physician in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Geriatric Medicine (Internal Medicine) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; 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.