Jersey City Pediatrics

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

MA41101 Issued in NJ

Legal business name

JERSEY CITY PEDIATRICS

Practice address

1 Journal Square PLZ
Jersey City, NJ 07306-4004

Phone

(201) 963-0090

NPI assigned

Feb 19, 2008

Last updated

Feb 19, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bandana Raha, M.D.NPI 1558365239

Title

Office Manager

Phone

(201) 963-0090

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• Bandana Raha, M.D.

  • Pediatrics Physician
  • Jersey City, NJ
  • NPI 1558365239
  Authorized official Same address or phone

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1861660219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 JOURNAL SQUARE PLZ",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073064004",
            "telephone_number": "201-963-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JOURNAL SQUARE PLZ",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073064004",
            "telephone_number": "201-963-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY CITY PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-19",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "RAHA",
        "authorized_official_first_name": "BANDANA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "201-963-0090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "NJ",
            "license": "MA41101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5475805",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jersey City Neck & Back Center, PC
• Jersey City Optometry PC
• Jersey City Oral Surgery & Dental Implant Center
• Jersey City Pathology Group, PA
• Jersey City Pediatric Dentistry, LLC
• Jersey City Physical Therapy
• Jersey City PT LLC (Town Physical Therapy - Jersey City)
• Jersey City Public Schools
• Jersey City Radiation Therapy LLC
• Jersey City Rehabilitation Clinic

• Preferred Provider Organization in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Preferred Provider Organization in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.