Organization Active NPI

New Brunswick Pediatric Group

  • Pediatrics Physician
  • North Brunswick, NJ
National Provider Identifier
1982604302
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
NEW BRUNSWICK PEDIATRIC GROUP
Practice address
1300 How LN
North Brunswick, NJ 08902-1721
Phone
(732) 247-1510
Fax
(732) 247-8885
NPI assigned
Jul 28, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Howard Ernest Wiener, MD
Title
Vice President
Phone
(732) 247-1510

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X NJ Primary

Addresses

Primary practice location

1300 How LN
North Brunswick, NJ 08902-1721

Mailing address

PO Box 6017
1300 How Lane
North Brunswick, NJ 08902-6017
Phone (732) 247-1510

Other identifiers 1

IdentifierTypeStateIssuer
2645009MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
New Brunswick Pediatric Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1982604302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6017",
            "address_2": "1300 HOW LANE",
            "city": "NORTH BRUNSWICK",
            "state": "NJ",
            "postal_code": "089026017",
            "telephone_number": "732-247-1510",
            "fax_number": "732-247-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 HOW LN",
            "city": "NORTH BRUNSWICK",
            "state": "NJ",
            "postal_code": "089021721",
            "telephone_number": "732-247-1510",
            "fax_number": "732-247-8885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW BRUNSWICK PEDIATRIC GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-28",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WIENER",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "ERNEST",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "732-247-1510",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2645009",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.