John a Renda MD PA,Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA014110200 Issued in NJ

Legal business name

JOHN A RENDA MD PA,INC

Practice address

200 Perrine Rd
Suite 231
Old Bridge, NJ 08857-2842

Phone

(732) 727-4774

Fax

(732) 727-4994

NPI assigned

Oct 5, 2010

Organization subpart

No

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

Authorized official

Name

John Anthony Renda, MD

Title

President

Phone

(732) 727-4774

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287446400000",
    "number": "1851600100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PERRINE RD",
            "address_2": "SUITE 231",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572842",
            "telephone_number": "732-727-4774",
            "fax_number": "732-727-4994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PERRINE RD",
            "address_2": "SUITE 231",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572842",
            "telephone_number": "732-727-4774",
            "fax_number": "732-727-4994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN A RENDA MD PA,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-05",
        "last_updated": "2010-10-19",
        "status": "A",
        "authorized_official_last_name": "RENDA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-727-4774",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA014110200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1055305",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Old Bridge, NJ
• Providers in Old Bridge, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.