Active NPI
Silver Lake Medical, PC
- Pain Medicine Physician
- Belleville, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine Physician
- License
- 25MB05752300
- Legal business name
- SILVER LAKE MEDICAL, PC
- Practice address
- 727 Joralemon St
Belleville, NJ 07109-1455 - Phone
- (973) 751-2060
- Fax
- (973) 751-2291
- NPI assigned
- Jun 15, 2018
- Last updated
- Jun 15, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Antonio Ciccone, DO
- Title
- Medical Director
- Phone
- (973) 751-2060
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | NU | ||
| Pain Medicine Physician | 208VP0000X | 25MB05752300 | NJ | Primary |
Addresses
Primary practice location
727 Joralemon St
Belleville, NJ 07109-1455
Mailing address
PO Box 599
Roseland, NJ 07068-0599
Phone (973) 901-1515
National Provider Directory
National Provider Directory- Tax ID family
- Silverlake Medical PC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Family Medicine Physician
- Belleville, NJ
- NPI 1538366679
Practitioners & affiliated clinicians
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529020800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1529020800000",
"number": "1750875589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 599",
"city": "ROSELAND",
"state": "NJ",
"postal_code": "070680599",
"telephone_number": "973-901-1515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "727 JORALEMON ST",
"city": "BELLEVILLE",
"state": "NJ",
"postal_code": "071091455",
"telephone_number": "973-751-2060",
"fax_number": "973-751-2291"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SILVER LAKE MEDICAL, PC",
"organizational_subpart": "NO",
"enumeration_date": "2018-06-15",
"last_updated": "2018-06-15",
"status": "A",
"authorized_official_last_name": "CICCONE",
"authorized_official_first_name": "ANTONIO",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "973-751-2060",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "208VP0000X",
"taxonomy_group": "",
"desc": "Pain Medicine, Pain Medicine",
"state": "NJ",
"license": "25MB05752300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belleville, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.