NPI Code Detail JSON Logo

1124931472 NPI number — NANCY J MOONTASRI MD LLC

NPI Number: 1124931472
Health Care Provider/Practitioner: NANCY J MOONTASRI MD LLC

Information about “1124931472” NPI (NANCY J MOONTASRI MD LLC) exists in 1124931472 in HTML format HTML  |  1124931472 in plain Text format TXT  |  1124931472 in PDF (Portable Document Format) PDF  |  1124931472 in an XML format XML  formats.

NPI Number : 1124931472 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1124931472",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "NANCY J MOONTASRI MD LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1 MARS CT STE 1",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BOONTON TWP",
    "MailingAddressStateName": "NJ",
    "MailingAddressPostalCode": "07005-2422",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "917-328-2401",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "106 PROSPECT ST STE 2",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "RIDGEWOOD",
    "PracticeLocationAddressStateName": "NJ",
    "PracticeLocationAddressPostalCode": "07450-4433",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "551-278-9776",
    "PracticeLocationAddressFaxNumber": "551-300-1306",
    "EnumerationDate": "09/28/2026",
    "LastUpdateDate": "09/28/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "MOONTASRI",
    "AuthorizedOfficialFirstName": "NANCY",
    "AuthorizedOfficialMiddleName": "J",
    "AuthorizedOfficialTitle": "SOLE MEMBER/OWNER",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "917-328-2401",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207X00000X",
        "TaxonomyName": "Orthopaedic Surgery Physician",
        "LicenseNumber": null,
        "LicenseNumberStateCode": "NULL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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