Organization Active NPI

St. Joseph's Regional Medical Center

  • Internal Medicine Physician
  • Elmwood Park, NJ
National Provider Identifier
1992113914
Registry record updated Jul 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
39
Legal business name
ST. JOSEPH'S REGIONAL MEDICAL CENTER
Practice address
400 Riverfront Blvd
119
Elmwood Park, NJ 07407-3600
Phone
(787) 679-4700
NPI assigned
Jul 23, 2014
Last updated
Jul 23, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2014

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

Authorized official

Name
Marianne Lanno
Title
Managed Care Physician Credentialin
Phone
(979) 754-2052

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 39 Primary

Addresses

Primary practice location

400 Riverfront Blvd
119
Elmwood Park, NJ 07407-3600

Mailing address

703 Main St
Paterson, NJ 07503-2621

Other identifiers 1

IdentifierTypeStateIssuer
072314OtherDOC NUMBER

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1406073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406073600000",
    "number": "1992113914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 RIVERFRONT BLVD",
            "address_2": "119",
            "city": "ELMWOOD PARK",
            "state": "NJ",
            "postal_code": "074073600",
            "telephone_number": "787-679-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH'S REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-23",
        "last_updated": "2014-07-23",
        "status": "A",
        "authorized_official_last_name": "LANNO",
        "authorized_official_first_name": "MARIANNE",
        "authorized_official_title_or_position": "MANAGED CARE PHYSICIAN CREDENTIALIN",
        "authorized_official_telephone_number": "979-754-2052"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": "39",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOC NUMBER",
            "identifier": "072314",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmwood Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; 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.