C and M Kintiroglou MD'S PA

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

25MA03124000 Issued in NJ

Legal business name

C AND M KINTIROGLOU MD'S PA

Practice address

1500 Pleasant Valley Way
Suite 301
West Orange, NJ 07052-2956

Phone

(973) 243-0002

NPI assigned

Jun 10, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Brigette Fullard

Title

Office Manager

Phone

(973) 243-0002

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Lauren Illya Kohlberg, C.P.N.P

  • Pediatric Nurse Practitioner
  • West Orange, NJ
  • NPI 1235252065
  NPD (past)

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307664000000",
    "number": "1689969396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 PLEASANT VALLEY WAY",
            "address_2": "SUITE 301",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 PLEASANT VALLEY WAY",
            "address_2": "SUITE 301",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522956",
            "telephone_number": "973-243-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C AND M KINTIROGLOU MD'S PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-10",
        "last_updated": "2011-06-10",
        "status": "A",
        "authorized_official_last_name": "FULLARD",
        "authorized_official_first_name": "BRIGETTE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "973-243-0002",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NJ",
            "license": "25MA03124000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Michael Bungarden
• Marisa Buonanno Hamrah, NP
• Monica Buoni, OTR/L
• Richlyn Eve Burnham, HEALTH COACH
• Michael John Buzzell, DPT
• Mary Cabarle, OTR/L
• Carl Allen Villanueva Cabrera
• Maria Ines Cabrera, APN
• Tania Manet Cabrera
• Joseph Richard Caccavo Jr., MPT

• Pediatric Adolescent Medicine Physician in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Pediatric Adolescent Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2011; 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.