NPIMap

Organization Active NPI

Bergen Gastroenterology PC

Doing business as Bergen Gastroenterology Paramus Office

  • Non-Pharmacy Dispensing Site
  • Paramus, NJ
National Provider Identifier
1659799328
Registry record updated Mar 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
25MA06565600 Issued in NJ
Legal business name
BERGEN GASTROENTEROLOGY PC
Doing business as
Bergen Gastroenterology Paramus Office
Practice address
1 W Ridgewood Ave
Suite 301
Paramus, NJ 07652-2359
Phone
(201) 445-1660
NPI assigned
Mar 31, 2014
Last updated
Mar 31, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDVANTX, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 31, 2014

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

Authorized official

Name
Kenny Heine
Title
VP of Operations
Phone
(858) 964-1506

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X 25MA06565600 NJ Primary

Addresses

Primary practice location

1 W Ridgewood Ave
Suite 301
Paramus, NJ 07652-2359

Mailing address

5626 Oberlin Dr
Suite 110
San Diego, CA 92121-1705

Other names 1

  • Bergen Gastroenterology Paramus Office Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bergen Gastroenterology3 organizations share this tax ID, including this one
Part of
Medvantx Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396224000000",
    "number": "1659799328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W RIDGEWOOD AVE",
            "address_2": "SUITE 301",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076522359",
            "telephone_number": "201-445-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERGEN GASTROENTEROLOGY PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2014-03-31",
        "last_updated": "2014-03-31",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "858-964-1506"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NJ",
            "license": "25MA06565600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bergen Gastroenterology Paramus Office",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paramus, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2014; 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.