NPIMap

Organization Active NPI

Jersey Coast Vascular Associates PA

  • Specialist
  • Brick, NJ
National Provider Identifier
1790711406
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA49111 Issued in NJ
Legal business name
JERSEY COAST VASCULAR ASSOCIATES PA
Practice address
425 Jack Martin Blvd
2ND Floor
Brick, NJ 08724-7732
Phone
(732) 202-1058
Fax
(732) 202-1588
NPI assigned
Jun 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2013

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

Authorized official

Name
Ms. Colleen Cosgrove
Title
Office Manager
Phone
(732) 202-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X MA49111 NJ Primary

Addresses

Primary practice location

425 Jack Martin Blvd
2ND Floor
Brick, NJ 08724-7732

Mailing address

425 Jack Martin Blvd
2ND Floor
Brick, NJ 08724-7732
Phone (732) 202-1058

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375228800000",
    "number": "1790711406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 JACK MARTIN BLVD",
            "address_2": "2ND FLOOR",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247732",
            "telephone_number": "732-202-1058",
            "fax_number": "732-202-1588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 JACK MARTIN BLVD",
            "address_2": "2ND FLOOR",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247732",
            "telephone_number": "732-202-1058",
            "fax_number": "732-202-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY COAST VASCULAR ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2013-07-31",
        "status": "A",
        "authorized_official_last_name": "COSGROVE",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "732-202-1500",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA49111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; 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.