Organization Active NPI

Pediatrics of South Brunswick PA

  • Pediatrics Physician
  • Dayton, NJ
National Provider Identifier
1972565356
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRICS OF SOUTH BRUNSWICK PA
Practice address
395 Ridge Rd
Suite 6
Dayton, NJ 08810-1398
Phone
(732) 274-2727
Fax
(732) 274-1662
NPI assigned
Apr 3, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Thomas A Genco, MDNPI 1497714398
Title
MD Owner
Phone
(732) 274-2727

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

395 Ridge Rd
Suite 6
Dayton, NJ 08810-1398

Mailing address

395 Ridge Rd
Suite 6
Dayton, NJ 08810-1398
Phone (732) 274-2727

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972565356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 RIDGE RD",
            "address_2": "SUITE 6",
            "city": "DAYTON",
            "state": "NJ",
            "postal_code": "088101398",
            "telephone_number": "732-274-2727",
            "fax_number": "732-274-1662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 RIDGE RD",
            "address_2": "SUITE 6",
            "city": "DAYTON",
            "state": "NJ",
            "postal_code": "088101398",
            "telephone_number": "732-274-2727",
            "fax_number": "732-274-1662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRICS OF SOUTH BRUNSWICK PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GENCO",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MD  OWNER",
        "authorized_official_telephone_number": "732-274-2727",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, NJ

Sources for this page

  • 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.