Active NPI
George Thalody, M.D.
- Nephrology Physician
- Elizabeth, NJ
National Provider Identifier
1679634778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- MA34780
- Practice address
- 240 Williamson St
Ste 400
Elizabeth, NJ 07202-3672 - Phone
- (908) 352-0560
- Fax
- (908) 352-4066
- NPI assigned
- Dec 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | MA34780 | NJ | Primary |
Addresses
Primary practice location
240 Williamson St
Ste 400
Elizabeth, NJ 07202-3672
Mailing address
240 Williamson St Ste 400
Elizabeth, NJ 07202-3672
Phone (908) 352-0560
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1146602 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA34780 | NJ | MD | Nephrology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269561600000",
"number": "1679634778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 WILLIAMSON ST STE 400",
"city": "ELIZABETH",
"state": "NJ",
"postal_code": "072023672",
"telephone_number": "908-352-0560",
"fax_number": "908-352-4066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 WILLIAMSON ST",
"address_2": "STE 400",
"city": "ELIZABETH",
"state": "NJ",
"postal_code": "072023672",
"telephone_number": "908-352-0560",
"fax_number": "908-352-4066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THALODY",
"first_name": "GEORGE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-12",
"last_updated": "2010-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "NJ",
"license": "MA34780",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1146602",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elizabeth, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.