Organization Active NPI

New Jersey Cancer and Integrated Medicine Center, LLC

  • Hematology & Oncology Physician
  • Englewood Cliffs, NJ
National Provider Identifier
1780150342
Registry record updated Mar 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
NEW JERSEY CANCER AND INTEGRATED MEDICINE CENTER, LLC
Practice address
464 Hudson Ter Ste 200
Englewood Cliffs, NJ 07632-2917
Phone
(201) 408-5442
NPI assigned
Oct 22, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2019

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

Authorized official

Name
Hai Sun ParkNPI 1508805839
Title
President
Phone
(201) 408-5442

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)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X Primary

Addresses

Primary practice location

464 Hudson Ter Ste 200
Englewood Cliffs, NJ 07632-2917

Mailing address

464 Hudson Ter Ste 201
Englewood Cliffs, NJ 07632-2917

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190130002798 NJ Part B Supplier - Clinic/Group Practice 8921345802 Receives reassigned benefits from 1 practitioner
Practice locations: Englewood, NJ

National Provider Directory

National Provider Directory

Locations

464 Hudson Ter
Ste 201
Englewood Cliffs, NJ 07632
Phone (201) 503-0828

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553644800000",
    "number": "1780150342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "464 HUDSON TER STE 201",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076322917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 HUDSON TER STE 200",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076322917",
            "telephone_number": "201-408-5442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW JERSEY CANCER AND INTEGRATED MEDICINE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-22",
        "last_updated": "2019-03-27",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "HAI SUN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-408-5442"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood Cliffs, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.