NPIMap

Organization Active NPI

Phillips Eye Center PA

  • Ophthalmology Physician
  • Elmwood Park, NJ
National Provider Identifier
1851471379
Registry record updated Jul 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
PHILLIPS EYE CENTER PA
Practice address
619 River Drive
Center One, Second Floor
Elmwood Park, NJ 07407
Phone
(201) 796-2020
Fax
(201) 796-2833
NPI assigned
Oct 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2010

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

Authorized official

Name
Kristen M Attenello
Title
Billing Manager
Phone
(201) 796-3330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

619 River Drive
Center One, Second Floor
Elmwood Park, NJ 07407

Mailing address

619 River Drive
Center One, Second Floor
Elmwood Park, NJ 07407
Phone (201) 796-2020

Other identifiers 1

IdentifierTypeStateIssuer
7265107MedicaidNJ

Other names 1

  • Hudson Eye Specialists Other name

National Provider Directory

National Provider Directory

Locations

619 River Dr
Fl 2
Elmwood Park, NJ 07407
Phone (201) 796-2020

619 River Dr
#12
Elmwood Park, NJ 07407

2201 Bergenline Ave
Union City, NJ 07087
Phone (201) 558-3700

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279756800000",
    "number": "1851471379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 RIVER DRIVE",
            "address_2": "CENTER ONE, SECOND FLOOR",
            "city": "ELMWOOD PARK",
            "state": "NJ",
            "postal_code": "07407",
            "telephone_number": "201-796-2020",
            "fax_number": "201-796-2833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 RIVER DRIVE",
            "address_2": "CENTER ONE, SECOND FLOOR",
            "city": "ELMWOOD PARK",
            "state": "NJ",
            "postal_code": "07407",
            "telephone_number": "201-796-2020",
            "fax_number": "201-796-2833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIPS EYE CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2010-07-22",
        "status": "A",
        "authorized_official_last_name": "ATTENELLO",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "201-796-3330"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7265107",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hudson Eye Specialists",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Elmwood Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.