Active NPI
Susan Mediterraneo, MD
- Pediatrics Physician
- Clifton, NJ
National Provider Identifier
1891798351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MS55031
- Practice address
- 1033 Route 46
Clifton, NJ 07013-2473 - Phone
- (973) 779-3911
- Fax
- (973) 471-2730
- NPI assigned
- May 27, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MS55031 | NJ | Primary |
Addresses
Primary practice location
1033 Route 46
Clifton, NJ 07013-2473
Mailing address
1033 Route 46
Clifton, NJ 07013-2473
Phone (973) 779-3911
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MS55031 | NJ | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1891798351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1033 ROUTE 46",
"city": "CLIFTON",
"state": "NJ",
"postal_code": "070132473",
"telephone_number": "973-779-3911",
"fax_number": "973-471-2730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1033 ROUTE 46",
"city": "CLIFTON",
"state": "NJ",
"postal_code": "070132473",
"telephone_number": "973-779-3911",
"fax_number": "973-471-2730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDITERRANEO",
"first_name": "SUSAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-05-27",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "MS55031",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clifton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.