NPIMap

Organization Active NPI

Laser Surgery New Jersey

  • Pain Medicine (Anesthesiology) Physician
  • Pompton Lakes, NJ
National Provider Identifier
1841546702
Registry record updated Jul 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
2MA07838400 Issued in NJ
Legal business name
LASER SURGERY NEW JERSEY
Practice address
111 Wanaque Ave
Pompton Lakes, NJ 07442-2101
Phone
(214) 615-5168
Fax
(888) 526-9542
NPI assigned
Jul 30, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2012

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

Authorized official

Name
Ms. Melanie Gross
Title
Director of Revenue Cycle
Phone
(214) 615-5168

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X 2MA07838400 NJ Primary

Addresses

Primary practice location

111 Wanaque Ave
Pompton Lakes, NJ 07442-2101

Mailing address

PO Box 3837
Carol Stream, IL 60132-3837
Phone (214) 615-5168

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343606400000",
    "number": "1841546702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3837",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601323837",
            "telephone_number": "214-615-5168",
            "fax_number": "888-526-9542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WANAQUE AVE",
            "city": "POMPTON LAKES",
            "state": "NJ",
            "postal_code": "074422101",
            "telephone_number": "214-615-5168",
            "fax_number": "888-526-9542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LASER SURGERY NEW JERSEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-30",
        "last_updated": "2012-07-30",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "214-615-5168",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NJ",
            "license": "2MA07838400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompton Lakes, NJ

Sources for this page

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