HACKENSACK UNIVERSITY MEDICAL GROUP, PC
NPI 1902563018
Emergency Medicine in Hackensack, NJ

Active since November 23, 2021CLIA 31D2122777 · Waiver
30 PROSPECT AVE, HACKENSACK, NJ 07601(551) 996-2000 Get Directions Write a Review

NPPES record last updated: November 23, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Hackensack University Medical Group, Pc NPPES

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

HACKENSACK UNIVERSITY MEDICAL GROUP, PC (NPI 1902563018) is a healthcare organization registered as an emergency medicine in Hackensack, New Jersey and active in the NPI registry since November 2021. The organization holds a CLIA Waiver certificate valid through March 30, 2027 and lists Larry Reznik, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1902563018
Entity TypeOrganization
Primary Taxonomy207P00000X
Legal Business NameHACKENSACK UNIVERSITY MEDICAL GROUP, PC
Location Address30 PROSPECT AVEHackensack, NJ 07601-1915
Mailing AddressPo Box 95000-8303Philadelphia, PA 19195-0001
Organization SubpartNo
Authorized OfficialLarry ReznikAuthorized Official · (551) 996-5045
Enumeration DateNovember 23, 2021
NPPES CertifiedNovember 23, 2021
NPI 1902563018 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

30 PROSPECT AVE, Hackensack, NJ 07601

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 31D2122777

Hackensack University Medical Group Pediatric Adolescent Medicine · Hackensack, NJ
Active · expires Mar 30, 2027
CLIA Number31D2122777
Laboratory TypePhysician Office
Certificate Effective DateMarch 31, 2025
Certificate Expiration DateMarch 30, 2027
Laboratory DirectorJennifer L. Northridge
Laboratory Phone(551) 996-2237
Laboratory LocationHackensack University Medical Group Pediatric Adolescent Medicine30 Prospect Avenue Wfan Building, Third Floor, Hackensack, NJ 07601
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

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

Obstetrics & Gynecology (Maternal & Fetal Medicine)
30 PROSPECT AVE
HACKENSACK, NJ 07601
Pediatrics (Adolescent Medicine)
30 PROSPECT AVE
HACKENSACK, NJ 07601
Emergency Medicine
30 PROSPECT AVE
HACKENSACK, NJ 07601
Emergency Medicine
30 PROSPECT AVE
HACKENSACK, NJ 07601
Nurse Practitioner (Adult Health)
30 PROSPECT AVE
HACKENSACK, NJ 07601
Anesthesiology
30 PROSPECT AVE
HACKENSACK, NJ 07601
Emergency Medicine
30 PROSPECT AVE
HACKENSACK, NJ 07601
Anesthesiology
30 PROSPECT AVE
HACKENSACK, NJ 07601

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 Hackensack University Medical Group, PC's NPI number?

The NPI number for Hackensack University Medical Group, PC is 1902563018. It was assigned to this organization in the NPPES registry on November 23, 2021.

Where is Hackensack University Medical Group, PC located?

Hackensack University Medical Group, PC is located at 30 Prospect Ave, Hackensack, NJ 07601. The listed phone number is (551) 996-2000.

What is Hackensack University Medical Group, PC's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Does Hackensack University Medical Group, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 31D2122777) is associated with this NPI, valid through March 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Hackensack University Medical Group, PC was last updated on November 23, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.