Njveincare, LLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

25MA06483700 Issued in NJ

Legal business name

NJVEINCARE, LLC

Practice address

1037 US Highway 46 Ste 202
Clifton, NJ 07013-2459

Phone

(739) 778-2222

NPI assigned

Oct 9, 2009

Organization subpart

No

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

Authorized official

Name

Gary B Nackman, MDNPI 1114096765

Title

Owner

Phone

(973) 778-2222

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

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

• Gary B Nackman, MD

  • Vascular Surgery Physician
  • Clifton, NJ
  • NPI 1114096765
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1255046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580169600000",
    "number": "1821323700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1037 US HIGHWAY 46",
            "address_2": "STE 202",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132459",
            "telephone_number": "973-778-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1037 US HIGHWAY 46 STE 202",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132459",
            "telephone_number": "739-778-2222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "950 W Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Union",
            "state": "NJ",
            "postal_code": "070836966",
            "country_code": "US",
            "telephone_number": "908-687-2552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NJVEINCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-09",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A",
        "authorized_official_last_name": "NACKMAN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-778-2222",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "NJ",
            "license": "25MA06483700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Vascular Surgery Physician in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Vascular Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.