Irvington Pediatric Associates, P.a.

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

25MA05388700 Issued in NJ

Legal business name

IRVINGTON PEDIATRIC ASSOCIATES, P.A.

Practice address

22 Ball St
Suite 100
Irvington, NJ 07111-3521

Phone

(973) 371-1600

NPI assigned

Jul 11, 2006

Last updated

Aug 22, 2020By 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

Bernier Lauredan, MDNPI 1639283047

Title

Medical Director

Phone

(973) 371-1600

Specialties & licenses 1

Addresses

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.

• Bernier Lauredan, M.D.

  • Preferred Provider Organization
  • Irvington, NJ
  • NPI 1639283047
  Authorized official Same address or phone

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770518698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BALL ST",
            "address_2": "SUITE 100",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071113521",
            "telephone_number": "973-371-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BALL ST",
            "address_2": "SUITE 100",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071113521",
            "telephone_number": "973-371-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRVINGTON PEDIATRIC ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LAUREDAN",
        "authorized_official_first_name": "BERNIER",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "973-371-1600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "NJ",
            "license": "25MA05388700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Irvington Health Care Providers, LLC (Alaris Health at Essex - Vent)
• Irvington Healthcare Providers LLC (Chancellor Specialty Care Center)
• Irvington Healthcare Providers LLC (chancellor specialty care center)
• Irvington Home Health Care LLC
• Irvington Medical Imaging P.C.
• Irvington Pharmacy LLC (Irvington Pharmacy)
• Irvington Physical Therapy
• Irvington Primary Care LLC
• Callista Ngozi Iwuala, APN-C
• Jennifer Iwudibia, PHARMD

• Preferred Provider Organization in Irvington, NJ
• Providers in Irvington, NJ by specialty
• Preferred Provider Organization in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.