Active NPI
St. Joseph's Regional Medical Center
- Internal Medicine Physician
- Elmwood Park, NJ
National Provider Identifier
1992113914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- 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, 2014
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 072314 | Other | DOC NUMBER |
National Provider Directory
National Provider DirectoryNPI 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.