Om Medical Group PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA04353300 Issued in NJ

Legal business name

OM MEDICAL GROUP PC

Practice address

23 Branford PL
Newark, NJ 07102-2711

Phone

(973) 424-0080

Fax

(973) 424-0088

NPI assigned

Sep 16, 2011

Last updated

Sep 29, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Robert D Collin, MD

Title

Director

Phone

(973) 424-0080

Specialties & licenses 1

Addresses

Other names 1

• BRANFORD MEDICAL CENTER Other name

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

{
    "created_epoch": "1316131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317254400000",
    "number": "1801178736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 BRANFORD PL",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071022711",
            "telephone_number": "973-424-0080",
            "fax_number": "973-424-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 BRANFORD PL",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071022711",
            "telephone_number": "973-424-0080",
            "fax_number": "973-424-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OM MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-16",
        "last_updated": "2011-09-29",
        "status": "A",
        "authorized_official_last_name": "COLLIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "973-424-0080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA04353300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BRANFORD MEDICAL CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Internal Medicine Physician in Newark, NJ
• Providers in Newark, 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 29, 2011; 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.