Glen Rock Pediatrics, PC

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

25MA09074400 Issued in NJ

Legal business name

GLEN ROCK PEDIATRICS, PC

Practice address

385 S Maple Ave
Suite 107a
Glen Rock, NJ 07452-1543

Phone

(201) 857-3111

Fax

(201) 857-3110

NPI assigned

Oct 12, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Dorina Halifman, M.D.

Title

President

Phone

(201) 857-3111

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dorina Halifman, MD Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1444608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444608000000",
    "number": "1750752135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 S MAPLE AVE",
            "address_2": "SUITE 107A",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074521543",
            "telephone_number": "201-857-3111",
            "fax_number": "201-857-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 S MAPLE AVE",
            "address_2": "SUITE 107A",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074521543",
            "telephone_number": "201-857-3111",
            "fax_number": "201-857-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEN ROCK PEDIATRICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-12",
        "last_updated": "2015-10-12",
        "status": "A",
        "authorized_official_last_name": "HALIFMAN",
        "authorized_official_first_name": "DORINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-857-3111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "NJ",
            "license": "25MA09074400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0346829",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dorina Halifman, MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rebecca Gasin
• Gatto Acupuncture & Wellness, LLC
• Benjamin Gertzog, DPT
• Jossana Ghobryal I, D.C.
• Laurie Anne Glass, PTA
• Glen Rock Physical Therapy and Sports Rehabilitation, Inc
• Jacquelyn Gnassi, LAC
• Eric Gonzalez, OTR/L
• Nicole Granert, DC
• Csilla Greiner, LPC

• Legal Medicine in Glen Rock, NJ
• Providers in Glen Rock, NJ by specialty
• Legal Medicine in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.