St Thomas Mediccal Center

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

25MA07777500 Issued in NJ

Legal business name

ST THOMAS MEDICCAL CENTER

Practice address

17 E 27TH St
Bayonne, NJ 07002-4608

Phone

(201) 436-0033

Fax

(201) 436-0079

NPI assigned

Oct 26, 2014

Last updated

Oct 26, 2014By 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. Joseph Ibrahim, MDNPI 1225068281

Title

Owner/MD

Phone

(201) 436-0033

Specialties & licenses 1

Addresses

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.

• Joseph G.a. Ibrahim, M.D.

  • Specialist
  • Bayonne, NJ
  • NPI 1225068281
  NPD (past) Authorized official

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

{
    "created_epoch": "1414281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414281600000",
    "number": "1962807552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 E 27TH ST",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070024608",
            "telephone_number": "201-436-0033",
            "fax_number": "201-436-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 E 27TH ST",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070024608",
            "telephone_number": "201-436-0033",
            "fax_number": "201-436-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST THOMAS MEDICCAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-26",
        "last_updated": "2014-10-26",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "201-436-0033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NJ",
            "license": "25MA07777500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St Ann Ortho Fitting LLC
• St George Clinic, Inc.
• St Maria Pharmacy (St Maria Pharmacy, Corp)
• St Marina Pharmacy Inc (St Marina Pharmacy)
• St Michael Dental Clinic Corporation
• St. Anthony Medical Lab
• Stat Medical Services
• Stat Medical Services LLC
• Steady Minds
• Shantell Crystal Steele, MD

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Bayonne, NJ
• Providers in Bayonne, NJ by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2014; 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.