Organization Active NPI

New Jersey Vascular LLC

  • Vascular Surgery Physician
  • Fairfield, NJ
National Provider Identifier
1841807161
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
NEW JERSEY VASCULAR LLC
Practice address
410 US Highway 46
Fairfield, NJ 07004-1972
Phone
(862) 210-8189
NPI assigned
Sep 30, 2020
Last updated
Sep 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Authorized official

Name
Ms. Deborah Hilderley
Title
Billing Agent
Phone
(352) 683-3855

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

410 US Highway 46
Fairfield, NJ 07004-1972

Mailing address

PO Box 104
East Hanover, NJ 07936-0104

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1601424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601424000000",
    "number": "1841807161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 104",
            "city": "EAST HANOVER",
            "state": "NJ",
            "postal_code": "079360104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 US HIGHWAY 46",
            "city": "FAIRFIELD",
            "state": "NJ",
            "postal_code": "070041972",
            "telephone_number": "862-210-8189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW JERSEY VASCULAR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-30",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A",
        "authorized_official_last_name": "HILDERLEY",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "BILLING AGENT",
        "authorized_official_telephone_number": "352-683-3855",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.