Edward a Mercogliano MD PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

25MA02603700 Issued in NJ

Legal business name

EDWARD A MERCOGLIANO MD PA

Practice address

181 Franklin Ave
Suite 305
Nutley, NJ 07110-3820

Phone

(973) 284-0370

Fax

(973) 667-8547

NPI assigned

Apr 25, 2011

Last updated

Apr 25, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Edward Anthony Merocgliano, MD

Title

Owner

Phone

(973) 284-0370

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edward Anthony Mercogliano, M.D.

  • Surgery Physician
  • Nutley, NJ
  • NPI 1285738229
  Medicare reassignment NPD

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

{
    "created_epoch": "1303689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303689600000",
    "number": "1720379878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 FRANKLIN AVE",
            "address_2": "SUITE 305",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071103820",
            "telephone_number": "973-284-0370",
            "fax_number": "973-667-8547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 FRANKLIN AVE",
            "address_2": "SUITE 305",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071103820",
            "telephone_number": "973-284-0370",
            "fax_number": "973-667-8547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD A MERCOGLIANO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-25",
        "last_updated": "2011-04-25",
        "status": "A",
        "authorized_official_last_name": "MEROCGLIANO",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-284-0370",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA02603700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2839300",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Nutley, NJ
• Providers in Nutley, 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 Apr 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.