NPIMap

Organization Active NPI

Eton Medical Group, PA

Doing business as Bergen Family Practice

  • Family Medicine Physician
  • Paramus, NJ
National Provider Identifier
1831244003
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MA05433300 Issued in NJ
Legal business name
ETON MEDICAL GROUP, PA
Doing business as
Bergen Family Practice
Practice address
1 Sears Drive
4TH Floor
Paramus, NJ 07652
Phone
(201) 261-6061
Fax
(201) 261-6465
NPI assigned
Jan 25, 2007
Last updated
Jun 30, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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

Authorized official

Name
Michael William Rutigliano Sr., MDNPI 1740348077
Title
President
Phone
(201) 261-6061

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X MA05433300 NJ Primary

Addresses

Primary practice location

1 Sears Drive
4TH Floor
Paramus, NJ 07652

Mailing address

1 Sears Drive
4TH Floor
Paramus, NJ 07652
Phone (201) 261-6061

Other names 1

  • Bergen Family Practice Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bergen Family Practice2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277856000000",
    "number": "1831244003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SEARS DRIVE",
            "address_2": "4TH FLOOR",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "07652",
            "telephone_number": "201-261-6061",
            "fax_number": "201-261-6465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SEARS DRIVE",
            "address_2": "4TH FLOOR",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "07652",
            "telephone_number": "201-261-6061",
            "fax_number": "201-261-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETON MEDICAL GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2010-06-30",
        "status": "A",
        "authorized_official_last_name": "RUTIGLIANO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-261-6061",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MA05433300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bergen Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paramus, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; 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.