Active NPI
Kamtorn Vangvanichyakorn, MD
- Neonatal-Perinatal Medicine Physician
- Livingston, NJ
National Provider Identifier
1699704825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- 25MA03573500
- Practice address
- 94 Old Short Hills Rd
Livingston, NJ 07039-5672 - Phone
- (973) 322-5213
- Fax
- (973) 322-8833
- NPI assigned
- Jul 1, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 25MA03573500 | NJ | Primary |
Addresses
Primary practice location
94 Old Short Hills Rd
Livingston, NJ 07039-5672
Mailing address
94 Old Short Hills Rd
Livingston, NJ 07039-5672
Phone (973) 322-5213
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5224004 | 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 |
|---|---|---|---|
| 25MA03573500 | NJ | MD | Neonatal-Perinatal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553040000000",
"number": "1699704825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94 OLD SHORT HILLS RD",
"city": "LIVINGSTON",
"state": "NJ",
"postal_code": "070395672",
"telephone_number": "973-322-5213",
"fax_number": "973-322-8833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94 OLD SHORT HILLS RD",
"city": "LIVINGSTON",
"state": "NJ",
"postal_code": "070395672",
"telephone_number": "973-322-5213",
"fax_number": "973-322-8833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANGVANICHYAKORN",
"first_name": "KAMTORN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-01",
"last_updated": "2019-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "NJ",
"license": "25MA03573500",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5224004",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Livingston, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.