NPIMap

Organization Active NPI

Liberty Health Jersy City Medical Center

  • Developmental - Behavioral Pediatrics Physician
  • Jersey City, NJ
National Provider Identifier
1700950482
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
MA01584800 Issued in NJ
Legal business name
LIBERTY HEALTH JERSY CITY MEDICAL CENTER
Practice address
953 Garfield Avenue
Jersey City, NJ 07304
Phone
(201) 915-2059
Fax
(201) 915-2551
NPI assigned
Nov 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Richard WM Goldsmith, MD
Title
Medical Director
Phone
(201) 915-2059

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0006X MA01584800 NJ Primary

Addresses

Primary practice location

953 Garfield Avenue
Jersey City, NJ 07304

Mailing address

953 Garfield Avenue
Center for Children & Special Needs
Jersey City, NJ 07304
Phone (201) 915-2059

Other identifiers 1

IdentifierTypeStateIssuer
0525901MedicaidNJ

Other names 1

  • Ctr for Children & Special Needs Other name

National Provider Directory

National Provider Directory
Tax ID family
Jean Robe Darbouze MD10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700950482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "953 GARFIELD AVENUE",
            "address_2": "CENTER FOR CHILDREN & SPECIAL NEEDS",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07304",
            "telephone_number": "201-915-2059",
            "fax_number": "201-915-2551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "953 GARFIELD AVENUE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07304",
            "telephone_number": "201-915-2059",
            "fax_number": "201-915-2551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY HEALTH JERSY CITY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOLDSMITH",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "WM",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "201-915-2059",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "NJ",
            "license": "MA01584800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0525901",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ctr for Children & Special Needs",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.