Organization Active NPI

Daughters of Miriam Ctr Physician Group

  • Geriatric Medicine (Internal Medicine) Physician
  • Clifton, NJ
National Provider Identifier
1699859249
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
DAUGHTERS OF MIRIAM CTR PHYSICIAN GROUP
Practice address
155 Hazel St
Clifton, NJ 07011-3423
Phone
(973) 253-5210
Fax
(973) 772-8243
NPI assigned
Oct 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Frank Dasilva
Title
Chief Financial Officer
Phone
(973) 253-5210

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X Primary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X

Addresses

Primary practice location

155 Hazel St
Clifton, NJ 07011-3423

Mailing address

155 Hazel St
Clifton, NJ 07011-3423
Phone (973) 253-5210

Other identifiers 1

IdentifierTypeStateIssuer
7063202MedicaidNJ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1699859249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 HAZEL ST",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070113423",
            "telephone_number": "973-253-5210",
            "fax_number": "973-772-8243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 HAZEL ST",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070113423",
            "telephone_number": "973-253-5210",
            "fax_number": "973-772-8243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAUGHTERS OF MIRIAM CTR PHYSICIAN GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "DASILVA",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "973-253-5210"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7063202",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.