Pediatrician in Monroe

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

25MA07639600 Issued in NJ

Legal business name

PEDIATRICIAN IN MONROE

Doing business as

Hanna Gebre Medhin

Practice address

18 Centre Dr
Suite 205
Monroe, NJ 08831-1501

Phone

(732) 561-7810

Fax

(732) 631-0742

NPI assigned

Nov 28, 2007

Organization subpart

No

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

Authorized official

Name

Hanna Gebre Medhin, M.D.

Title

Pediatrician

Phone

(732) 561-7810

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Hanna Gebre Medhin Doing business as

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349049600000",
    "number": "1780866129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 SUMMERFIELD DR",
            "city": "MONROE",
            "state": "NJ",
            "postal_code": "088313275",
            "telephone_number": "732-561-7810",
            "fax_number": "732-631-0742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 CENTRE DR",
            "address_2": "SUITE 205",
            "city": "MONROE",
            "state": "NJ",
            "postal_code": "088311501",
            "telephone_number": "732-561-7810",
            "fax_number": "732-631-0742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRICIAN IN MONROE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2012-10-01",
        "status": "A",
        "authorized_official_last_name": "GEBRE MEDHIN",
        "authorized_official_first_name": "HANNA",
        "authorized_official_title_or_position": "PEDIATRICIAN",
        "authorized_official_telephone_number": "732-561-7810",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NJ",
            "license": "25MA07639600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0148695",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hanna Gebre Medhin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinic/Center in Monroe, NJ
• Providers in Monroe, NJ by specialty
• Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; 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.