Mount Prospect Medical Group,LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA07308500 Issued in NJ

Legal business name

MOUNT PROSPECT MEDICAL GROUP,LLC

Practice address

570 Park Ave
2ND Floor
East Orange, NJ 07017-1904

Phone

(973) 672-8573

Fax

(973) 675-0040

NPI assigned

Feb 12, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Alexander G Salerno, M.D.

Title

Owner/President

Phone

(973) 672-2455

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455235200000",
    "number": "1700245255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 PARK AVE",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070171905",
            "telephone_number": "973-672-2455",
            "fax_number": "973-675-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 PARK AVE",
            "address_2": "2ND FLOOR",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070171904",
            "telephone_number": "973-672-8573",
            "fax_number": "973-675-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT PROSPECT MEDICAL GROUP,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-12",
        "last_updated": "2016-02-12",
        "status": "A",
        "authorized_official_last_name": "SALERNO",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "973-672-2455",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA07308500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madeleine Morin
• Christopher Morrell, M.D.
• Eboni Morris, BCPA
• Michael G Moschella, CPO
• Leslie Vanessa Mosquera-Sotelo
• Anderly Moya
• Jovitha Lili-Uwase Mudacumura, M.A.
• Fatimah Muhammad
• Gibran Muhammad
• Sarah Mulligan

• Internal Medicine Physician in East Orange, NJ
• Providers in East Orange, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2016; 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.