St George Clinic, Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA06522100 Issued in NJ

Legal business name

ST GEORGE CLINIC, INC.

Practice address

862 Broadway
Bayonne, NJ 07002-3054

Phone

(201) 339-4811

Fax

(201) 339-4402

NPI assigned

Jan 12, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Joseph S Saleeb, M.D.NPI 1982624581

Title

Physician

Phone

(201) 339-4811

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Joseph S. Saleeb Other name

Medicare fee-for-service enrollment

Enrolled in NJ2 enrollments

Enrollment records 2

Locations

Practitioners 1

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

• Joseph S. Saleeb, MD, F.A.C.G.S.

  • Internal Medicine Physician
  • Bayonne, NJ
  • NPI 1982624581
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1263254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271721600000",
    "number": "1780914879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3455 KENNEDY BLVD",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073074107",
            "telephone_number": "201-533-0003",
            "fax_number": "201-533-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "862 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023054",
            "telephone_number": "201-339-4811",
            "fax_number": "201-339-4402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST GEORGE CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-12",
        "last_updated": "2010-04-20",
        "status": "A",
        "authorized_official_last_name": "SALEEB",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "201-339-4811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA06522100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7831102",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Joseph S. Saleeb",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Internal Medicine Physician in Bayonne, NJ
• Providers in Bayonne, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2010; 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.