Organization Active NPI

Cgganjhos LLC

  • Clinic/Center
  • Park Ridge, NJ
National Provider Identifier
1649019258
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
CGGANJHOS LLC
Practice address
8 Glenbrook Dr
Park Ridge, NJ 07656-1808
Phone
(845) 596-3760
NPI assigned
May 22, 2024
Last updated
May 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Authorized official

Name
Erik SvenssonNPI 1770879371
Title
MD
Phone
(845) 596-3760

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

8 Glenbrook Dr
Park Ridge, NJ 07656-1808

Mailing address

8 Glenbrook Dr
Park Ridge, NJ 07656-1808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240530000093 NJ Part B Supplier - Clinic/Group Practice 4981046489 Receives reassigned benefits from 1 practitioner
Practice locations: Park Ridge, NJ; Hackensack, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1716336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716336000000",
    "number": "1649019258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 GLENBROOK DR",
            "city": "PARK RIDGE",
            "state": "NJ",
            "postal_code": "076561808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 GLENBROOK DR",
            "city": "PARK RIDGE",
            "state": "NJ",
            "postal_code": "076561808",
            "telephone_number": "845-596-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CGGANJHOS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A",
        "authorized_official_last_name": "SVENSSON",
        "authorized_official_first_name": "ERIK",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "845-596-3760"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.