NPIMap

Organization Active NPI

Meadowlands Physicians Professional Association

  • General Practice Physician
  • Secaucus, NJ
National Provider Identifier
1669728283
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
MEADOWLANDS PHYSICIANS PROFESSIONAL ASSOCIATION
Practice address
55 Meadowlands Pkwy
Secaucus, NJ 07094-2977
Phone
(201) 982-4706
NPI assigned
Aug 1, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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

Authorized official

Name
Mr. Roman Kosiborod, D.O.
Title
Owner
Phone
(201) 982-4706

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

55 Meadowlands Pkwy
Secaucus, NJ 07094-2977

Mailing address

55 Meadowlands Pkwy
Secaucus, NJ 07094-2977
Phone (201) 982-4706

National Provider Directory

National Provider Directory

Locations

55 Meadowlands Pkwy
Ste 1
Secaucus, NJ 07094
Phone (201) 392-3190

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1343779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355788800000",
    "number": "1669728283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 MEADOWLANDS PKWY",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070942977",
            "telephone_number": "201-982-4706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MEADOWLANDS PKWY",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070942977",
            "telephone_number": "201-982-4706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEADOWLANDS PHYSICIANS PROFESSIONAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-01",
        "last_updated": "2012-12-18",
        "status": "A",
        "authorized_official_last_name": "KOSIBOROD",
        "authorized_official_first_name": "ROMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-982-4706",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Secaucus, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; 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.