Bloomfield Pediatrics,P.a.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

MA065388 Issued in NJ

Legal business name

BLOOMFIELD PEDIATRICS,P.A.

Practice address

329 Belleville Avenue
2ND Floor
Bloomfield, NJ 07003-5902

Phone

(973) 743-0202

Fax

(973) 743-0777

NPI assigned

Mar 22, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Edna Retiracion Lopez-Maslak, M.D.

Title

Owner

Phone

(973) 743-0202

Specialties & licenses 1

Addresses

Other identifiers 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2676/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333324800000",
    "number": "1831215896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 BELLEVILLE AVENUE",
            "address_2": "2ND FLOOR",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070035902",
            "telephone_number": "973-743-0202",
            "fax_number": "973-743-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 BELLEVILLE AVENUE",
            "address_2": "2ND FLOOR",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070035902",
            "telephone_number": "973-743-0202",
            "fax_number": "973-743-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMFIELD PEDIATRICS,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2012-04-02",
        "status": "A",
        "authorized_official_last_name": "LOPEZ-MASLAK",
        "authorized_official_first_name": "EDNA",
        "authorized_official_middle_name": "RETIRACION",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-743-0202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NJ",
            "license": "MA065388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8148309",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bloomfield Dental Designs
• Bloomfield Drugs LLC
• Bloomfield Emergency Medical Services Inc
• Bloomfield Foot & Ankle , LLC
• Bloomfield Health Services, LLC
• Bloomfield Pharmacy LLC
• Bloomfield Spine & Rehabilitation
• Bloomfield Surgi-Center, LLC
• Bloomfield Total Health Center
• Bloomfield Wellness Center

• Pediatric Adolescent Medicine Physician in Bloomfield, NJ
• Providers in Bloomfield, NJ by specialty
• Pediatric Adolescent Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; 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.