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OLD BERGEN PEDIATRICS PA
NPI 1053541599
Pediatrics in Jersey City, NJ

Active since July 17, 2009CLIA 31D2158609 · Waiver
4 HIGHLAND AVE, JERSEY CITY, NJ 07306(201) 434-3997(201) 434-3304 Get Directions Write a Review

NPPES record last updated: July 17, 2009. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Old Bergen Pediatrics Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OLD BERGEN PEDIATRICS PA (NPI 1053541599) is a healthcare organization registered as a pediatrics in Jersey City, New Jersey and active in the NPI registry since July 2009. The organization holds a CLIA Waiver certificate valid through December 2, 2026 and lists Eduardo Mangosing, President, as its authorized official.

NPPES Registry Identity

NPI1053541599
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameOLD BERGEN PEDIATRICS PA
Location Address4 HIGHLAND AVEJersey City, NJ 07306-4510
Mailing Address4 Highland AveJersey City, NJ 07306-4510 · (201) 434-3997 · Fax (201) 434-3304
Phone(201) 434-3997
Fax(201) 434-3304
Organization SubpartNo
Authorized OfficialEduardo MangosingPresident · (201) 434-3997
Enumeration DateJuly 17, 2009
✔ NPI 1053541599 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in NJ · 25MA06888600
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
4 HIGHLAND AVE, Jersey City, NJ 07306
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 31D2158609

Old Bergen Pediatrics · Jersey City, NJ
Active · expires Dec 2, 2026
CLIA Number31D2158609
Laboratory TypePhysician Office
Certificate Effective DateDecember 3, 2024
Certificate Expiration DateDecember 2, 2026
Laboratory DirectorNelo Dimaculangan
Laboratory Phone(201) 434-3997
Laboratory LocationOld Bergen Pediatrics4 Highland Avenue, Jersey City, NJ 07306
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. NELO DIMACULANGAN M.D.
Pediatrics
4 HIGHLAND AVE
JERSEY CITY, NJ 07306
Hudson County (201) 434-3997

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Old Bergen Pediatrics PA's NPI number?

The NPI number for Old Bergen Pediatrics PA is 1053541599. It was assigned to this organization in the NPPES registry on July 17, 2009.

Where is Old Bergen Pediatrics PA located?

Old Bergen Pediatrics PA is located at 4 Highland Ave, Jersey City, NJ 07306. The listed phone number is (201) 434-3997.

What is Old Bergen Pediatrics PA's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Old Bergen Pediatrics PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 31D2158609) is associated with this NPI, valid through December 2, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Old Bergen Pediatrics PA was last updated on July 17, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.