Organization Active NPI

South Jersey Pain Management

  • Pain Medicine (Anesthesiology) Physician
  • Galloway, NJ
National Provider Identifier
1992035190
Registry record updated Jul 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
25MD02391600 Issued in NJ
Legal business name
SOUTH JERSEY PAIN MANAGEMENT
Practice address
76 West Jim Leeds Rd Park Centre
Suite 501
Galloway, NJ 08205-9411
Phone
(609) 568-5567
Fax
(609) 568-5614
NPI assigned
Jan 11, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2012

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

Authorized official

Name
Salvatore Joseph Cerniglia, DO
Title
Physician
Phone
(609) 568-5567

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X 25MD02391600 NJ Primary

Addresses

Primary practice location

76 West Jim Leeds Rd Park Centre
Suite 501
Galloway, NJ 08205-9411

Mailing address

76 West Jim Leeds Rd - Park Centre
Suite 501
Galloway, NJ 08205-9411
Phone (609) 568-5567

Other identifiers 1

IdentifierTypeStateIssuer
1725301MedicaidNJ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1263168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343088000000",
    "number": "1992035190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 WEST JIM LEEDS RD - PARK CENTRE",
            "address_2": "SUITE 501",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059411",
            "telephone_number": "609-568-5567",
            "fax_number": "609-568-5614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 WEST JIM LEEDS RD PARK CENTRE",
            "address_2": "SUITE 501",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059411",
            "telephone_number": "609-568-5567",
            "fax_number": "609-568-5614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH JERSEY PAIN MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-11",
        "last_updated": "2012-07-24",
        "status": "A",
        "authorized_official_last_name": "CERNIGLIA",
        "authorized_official_first_name": "SALVATORE",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "609-568-5567",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NJ",
            "license": "25MD02391600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1725301",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galloway, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; 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.