NPIMap

Organization Active NPI

Tiefenbrunn & Fortin Pediatrics

  • Pediatrics Physician
  • East Brunswick, NJ
National Provider Identifier
1760656532
Registry record updated Mar 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MA047770 Issued in NJ
Legal business name
TIEFENBRUNN & FORTIN PEDIATRICS
Practice address
503 Cranbury Rd
East Brunswick, NJ 08816-3612
Phone
(732) 390-8400
NPI assigned
Apr 14, 2008
Last updated
Mar 15, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2017

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

Authorized official

Name
Lisa Warren
Title
Office Manager
Phone
(732) 390-8400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MA047770 NJ Primary

Addresses

Primary practice location

503 Cranbury Rd
East Brunswick, NJ 08816-3612

Mailing address

503 Cranbury Rd
East Brunswick, NJ 08816-3612
Phone (732) 390-8400

Other identifiers 4

IdentifierTypeStateIssuer
MA047770OtherNJLICENSE NUMBER
MA069507OtherNJLICENSE NUMBER
26NJ00146700OtherNJNJ STATE LICENSE
MA055583OtherNJLICENSE NUMBER

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1208131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489536000000",
    "number": "1760656532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 CRANBURY RD",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163612",
            "telephone_number": "732-390-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 CRANBURY RD",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163612",
            "telephone_number": "732-390-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIEFENBRUNN & FORTIN PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-14",
        "last_updated": "2017-03-15",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "732-390-8400"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "MA047770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "MA047770",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "MA069507",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ STATE LICENSE",
            "identifier": "26NJ00146700",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "MA055583",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; 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.