Organization Active NPI

Ligaya Prystowsky MD PC

  • Ophthalmology Physician
  • Nutley, NJ
National Provider Identifier
1962690545
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
LIGAYA PRYSTOWSKY MD PC
Practice address
665 Franklin Ave
Nutley, NJ 07110-1209
Phone
(973) 667-4008
Fax
(973) 667-1655
NPI assigned
Oct 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Authorized official

Name
Dr. Ligaya Prystowsky, MD
Title
Principal
Phone
(973) 667-4008

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X NJ Primary

Addresses

Primary practice location

665 Franklin Ave
Nutley, NJ 07110-1209

Mailing address

665 Franklin Ave
Nutley, NJ 07110-1209
Phone (973) 667-4008

Other identifiers 1

IdentifierTypeStateIssuer
1582003MedicaidNJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191888000000",
    "number": "1962690545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 FRANKLIN AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071101209",
            "telephone_number": "973-667-4008",
            "fax_number": "973-667-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 FRANKLIN AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071101209",
            "telephone_number": "973-667-4008",
            "fax_number": "973-667-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGAYA PRYSTOWSKY MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2007-10-09",
        "status": "A",
        "authorized_official_last_name": "PRYSTOWSKY",
        "authorized_official_first_name": "LIGAYA",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "973-667-4008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1582003",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nutley, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; 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.