Edison Medical Center LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA05985700 Issued in NJ

Legal business name

EDISON MEDICAL CENTER LLC

Practice address

1819 Oak Tree Rd
Edison, NJ 08820-2740

Phone

(732) 603-6003

Fax

(732) 662-7082

NPI assigned

Jan 14, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Janardhan Bollu, MD

Title

Owner

Phone

(732) 603-6003

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1452729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488412800000",
    "number": "1891151247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 OAK TREE RD",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088202740",
            "telephone_number": "732-603-6003",
            "fax_number": "732-662-7082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 OAK TREE RD",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088202740",
            "telephone_number": "732-603-6003",
            "fax_number": "732-662-7082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDISON MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-14",
        "last_updated": "2017-03-02",
        "status": "A",
        "authorized_official_last_name": "BOLLU",
        "authorized_official_first_name": "JANARDHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-603-6003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA05985700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edison Healthcare Management LLC
• Edison Ig Cards LLC
• Edison Imaging Associates PA
• Edison Medical Associates LLC
• Edison Medical Care, LLC
• Edison Medical Health Care LLC
• Edison Medical Imaging
• Edison Medical Nutrition Center
• Edison Metuchen Orthopaedic Group PA
• Edison Nephrorlogy Consultants

• Internal Medicine Physician in Edison, NJ
• Providers in Edison, 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 Mar 2, 2017; 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.