Organization Active NPI

Jersey DTX LLC

  • Neurology Physician
  • Old Bridge, NJ
National Provider Identifier
1972380285
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
JERSEY DTX LLC
Practice address
14 Woodward Dr Ste 1a
Old Bridge, NJ 08857-3374
Phone
(732) 360-2888
NPI assigned
Sep 11, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Authorized official

Name
Padmarekha Rao, MD
Title
Director
Phone
(732) 360-2888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

14 Woodward Dr Ste 1a
Old Bridge, NJ 08857-3374

Mailing address

14 Woodward Dr Ste 1a
Old Bridge, NJ 08857-3374
Phone (732) 360-2888

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1694390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694390400000",
    "number": "1972380285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 WOODWARD DR STE 1A",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088573374",
            "telephone_number": "732-360-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 WOODWARD DR STE 1A",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088573374",
            "telephone_number": "732-360-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY DTX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A",
        "authorized_official_last_name": "RAO",
        "authorized_official_first_name": "PADMAREKHA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "732-360-2888",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Bridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.