Ar Medical PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD436215 Issued in PA

Legal business name

AR MEDICAL PC

Practice address

6100 Woodland Ave
Philadelphia, PA 19142-3224

Phone

(732) 306-1724

Fax

(267) 535-2757

NPI assigned

Dec 15, 2010

Organization subpart

No

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

Authorized official

Name

Alexander Rusanov, M.D.

Title

Medical Director/President

Phone

(732) 306-1724

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1292371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292371200000",
    "number": "1780987610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 VETERANS HWY",
            "address_2": "SUITE A-1 BOX 845",
            "city": "BRISTOL",
            "state": "PA",
            "postal_code": "190072512",
            "telephone_number": "732-306-1724",
            "fax_number": "267-535-2757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 WOODLAND AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191423224",
            "telephone_number": "732-306-1724",
            "fax_number": "267-535-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AR MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-15",
        "last_updated": "2010-12-15",
        "status": "A",
        "authorized_official_last_name": "RUSANOV",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/PRESIDENT",
        "authorized_official_telephone_number": "732-306-1724",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD436215",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD436215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Philadelphia, PA
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• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2010; 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.