J S Moukdad MD LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MA61069 Issued in NJ

Legal business name

J S MOUKDAD MD LLC

Practice address

1265 Paterson Plank Rd
Suite 3 B
Secaucus, NJ 07094-3242

Phone

(201) 223-1121

Fax

(201) 223-1126

NPI assigned

Sep 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jihad S Moukdad, MDNPI 1235221094

Title

President

Phone

(201) 223-1121

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 2

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

• Jihad S Moukdad

  • Internal Medicine Physician
  • Secaucus, NJ
  • NPI 1235221094
  Medicare reassignment NPD Authorized official
• Amanda Moukdad

  • Internal Medicine Physician
  • North Bergen, NJ
  • NPI 1326605528
  Medicare reassignment NPD

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190246400000",
    "number": "1801082136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 PATERSON PLANK RD",
            "address_2": "SUITE 3B",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070943242",
            "telephone_number": "201-223-1121",
            "fax_number": "201-223-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 PATERSON PLANK RD",
            "address_2": "SUITE 3 B",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070943242",
            "telephone_number": "201-223-1121",
            "fax_number": "201-223-1126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J S MOUKDAD MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-09-20",
        "status": "A",
        "authorized_official_last_name": "MOUKDAD",
        "authorized_official_first_name": "JIHAD",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-223-1121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA61069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Secaucus, NJ
• Providers in Secaucus, 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 Sep 20, 2007; 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.