Keystone Internal Medicine and Weight Loss Center LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

KEYSTONE INTERNAL MEDICINE AND WEIGHT LOSS CENTER LLC

Practice address

255 West Spring Valley Ave
Second Floor, Suite 200
Maywood, NJ 07607

Phone

(201) 447-3690

NPI assigned

Jun 2, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Pollytia Irene Panagiotou, MD

Title

Medical Director

Phone

(201) 447-3690

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1559433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561593600000",
    "number": "1871151118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1461",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074511461",
            "telephone_number": "201-450-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 WEST SPRING VALLEY AVE",
            "address_2": "SECOND FLOOR, SUITE 200",
            "city": "MAYWOOD",
            "state": "NJ",
            "postal_code": "07607",
            "telephone_number": "201-447-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE INTERNAL MEDICINE AND WEIGHT LOSS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-02",
        "last_updated": "2019-06-27",
        "status": "A",
        "authorized_official_last_name": "PANAGIOTOU",
        "authorized_official_first_name": "POLLYTIA",
        "authorized_official_middle_name": "IRENE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "201-447-3690",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Yee-Ming Kei, M.D.
• Julie Michelle Keller, MD
• Julwel Ann Kenney, PHD, MS, CDC, CPCMP
• Keystone Cardiovascular Center LLC
• Keystone Geriatric Specialists of New Jersey LLC
• Baron Kim
• Michael Kim
• Richard Kim, MD
• Stephanie Konrad, DNP, PMHNP
• Ketan Harshadray Kutlerywala, OD

• Internal Medicine Physician in Maywood, NJ
• Providers in Maywood, 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 Jun 27, 2019; 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.