Heritage Breast Care LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

HERITAGE BREAST CARE LLC

Practice address

741 Teaneck Rd
Suite B
Teaneck, NJ 07666-4243

Phone

(201) 833-2888

Fax

(201) 833-1010

NPI assigned

Jun 18, 2013

Organization subpart

No

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

Authorized official

Name

Moira K Christoudias, M.D.

Title

Breast Surgeon

Phone

(201) 833-2888

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1371513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371513600000",
    "number": "1700225216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 TEANECK RD",
            "address_2": "SUITE B",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664243",
            "telephone_number": "201-833-2888",
            "fax_number": "201-833-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 TEANECK RD",
            "address_2": "SUITE B",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664243",
            "telephone_number": "201-833-2888",
            "fax_number": "201-833-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE BREAST CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-18",
        "last_updated": "2013-06-18",
        "status": "A",
        "authorized_official_last_name": "CHRISTOUDIAS",
        "authorized_official_first_name": "MOIRA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "BREAST SURGEON",
        "authorized_official_telephone_number": "201-833-2888",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lacey M Herald, PA
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• Kevin Herman, M.D.
• Hitandewy J Hernandez-Herrera
• Iris Nereyda Hernandez, BCBA

• Surgery Physician in Teaneck, NJ
• Providers in Teaneck, NJ by specialty
• Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; 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.