NPIMap

Organization Active NPI

Mona M Tantawi,MD,PC

Doing business as Hackensack Pediatrics

  • Corporate Health Clinic/Center
  • Hackensack, NJ
National Provider Identifier
1831264316
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corporate Health Clinic/CenterTaxonomy code 261QC1800X
License
25MA03599800 Issued in NJ
Legal business name
MONA M TANTAWI,MD,PC
Doing business as
Hackensack Pediatrics
Practice address
177 Summit Ave
Hackensack, NJ 07601-1311
Phone
(201) 487-8222
Fax
(207) 487-2126
NPI assigned
Nov 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mona M Tantawi, M.D.NPI 1104873272
Title
Presedent
Phone
(201) 487-8222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corporate Health Clinic/Center 261QC1800X 25MA03599800 NJ Primary

Addresses

Primary practice location

177 Summit Ave
Hackensack, NJ 07601-1311

Mailing address

177 Summit Ave
Hackensack, NJ 07601-1311
Phone (201) 487-8222

Other names 1

  • Hackensack Pediatrics Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D0111661Hackensack Pediatrics177 Summit Ave, Hackensack, NJ 07601Certificate of waiverSep 19, 2027

National Provider Directory

National Provider Directory

Locations

177 Summit Ave
Hackensack, NJ 07601
Phone (201) 487-8222

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831264316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 SUMMIT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011311",
            "telephone_number": "201-487-8222",
            "fax_number": "207-487-2126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 SUMMIT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011311",
            "telephone_number": "201-487-8222",
            "fax_number": "207-487-2126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONA M TANTAWI,MD,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TANTAWI",
        "authorized_official_first_name": "MONA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESEDENT",
        "authorized_official_telephone_number": "201-487-8222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QC1800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Corporate Health",
            "state": "NJ",
            "license": "25MA03599800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hackensack Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.