Mainbridge Medical

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MAINBRIDGE MEDICAL

Practice address

1 Mainbridge LN
Willingboro, NJ 08046-2103

Phone

(609) 877-0646

Fax

(609) 877-0370

NPI assigned

May 11, 2006

Last updated

Aug 22, 2020By 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

Leonard S Katz, D.O.

Title

Owner

Phone

(609) 877-0644

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

Practitioners 2

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.

• Walter M Comiskey, DO

  • Internal Medicine Physician
  • Willingboro, NJ
  • NPI 1457572802
  NPD (past)
• Christopher Salerno, DO

  • Family Medicine Physician
  • Willingboro, NJ
  • NPI 1194838060
  NPD (past)

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972553642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8627",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080020627",
            "telephone_number": "856-755-1616",
            "fax_number": "856-755-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MAINBRIDGE LN",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080462103",
            "telephone_number": "609-877-0646",
            "fax_number": "609-877-0370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINBRIDGE MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KATZ",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-877-0644",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH ADMINISTRATOR",
            "identifier": "019423",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "10169",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "5868520",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8159009",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH HMO/PPO",
            "identifier": "0471676001",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Marie Luceri, D.O.
• Beth Anne Lucia, LSW
• Lyons Support Services
• Haley Macnair
• Randall F Maguire, MD
• Vicky L. Major, LSW, LCADC
• Pamela M Malatino
• Manish Gulshan Malik, MD
• Cynthia Louise Malin, APN
• Barbara Mang, LCSW

• Family Medicine Physician in Willingboro, NJ
• Providers in Willingboro, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.