Primary Care Network at Raritan Bay Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

25MA07867800 Issued in NJ

Legal business name

PRIMARY CARE NETWORK AT RARITAN BAY INC

Practice address

466 New Brunswick Ave
Perth Amboy, NJ 08861-3647

Phone

(732) 324-5140

NPI assigned

Jun 28, 2006

Organization subpart

No

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

Authorized official

Name

John Hailperin

Title

Managed Care

Phone

(201) 818-9118

Specialties & licenses 1

Addresses

Other identifiers 5

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Jao, MD

  • Pediatric Infectious Diseases Physician
  • Chicago, IL
  • NPI 1295779908

  Specialist

  NPD (past)

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1982631388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 48277",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071014800",
            "telephone_number": "201-818-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "466 NEW BRUNSWICK AVE",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613647",
            "telephone_number": "732-324-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE NETWORK AT RARITAN BAY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-28",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "HAILPERIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGED CARE",
        "authorized_official_telephone_number": "201-818-9118"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA07867800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEDS AMERIHEALTH GROUP #",
            "identifier": "2682252000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEDS AETNA PPO GROUP #",
            "identifier": "7141058",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEDS GHI PPO GROUP #",
            "identifier": "8219701",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEDS AETNA HMO GROUP #",
            "identifier": "0707547",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IM GHI PPO GROUP #",
            "identifier": "8219701",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sunil Porecha, D.D.S.
• Ernesto Rafael Portillo Diaz, MD
• Gloria I. Pou, DDS
• Joellys Pratts
• Precision Eye Physicians & Surgeons
• Progressive Spine & Orthopaedics, LLC
• Nicholas Prospero
• Puerto Rican Association for Human Development, Inc
• Puerto Rican Association for Human Development, Inc
• Saeed Qadar

• Specialist in Perth Amboy, NJ
• Providers in Perth Amboy, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.