Progressive Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MA63880 Issued in NJ

Legal business name

PROGRESSIVE PEDIATRICS

Practice address

3196 Kennedy Blvd
3Rd Floor
Union City, NJ 07087-2436

Phone

(201) 319-9800

Fax

(201) 319-9849

NPI assigned

Dec 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Noha Polack, MD

Title

President

Phone

(201) 319-9800

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329436800000",
    "number": "1750441333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3196 KENNEDY BLVD",
            "address_2": "3RD FLOOR",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070872436",
            "telephone_number": "201-319-9800",
            "fax_number": "201-319-9849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3196 KENNEDY BLVD",
            "address_2": "3RD FLOOR",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070872436",
            "telephone_number": "201-319-9800",
            "fax_number": "201-319-9849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2012-02-17",
        "status": "A",
        "authorized_official_last_name": "POLACK",
        "authorized_official_first_name": "NOHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-319-9800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "MA63880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0252573",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alejandro Presilla, MD
• Prime Aid Pharmacy Corp
• Prime Pharmacy Group LLC
• Pro Medquip
• Progressive Medical Imaging of Union City, LLC
• Daisy Pujals, L.S.W.
• Diana L Punales Morejon, PHD
• Clementino Purisima, MD
• Jonathan Grecia Purisima, DPM
• R.E.M. Medical

• Pediatrics Physician in Union City, NJ
• Providers in Union City, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; 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.