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125 Chubb Ave Suite 100-s Lyndhurst NJ 07071-3504 | |
| (201) 559-7600 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 125 Chubb Ave, Lyndhurst, New Jersey |
| Authorized Official Name and Position | Kelly Fontana (DIRECTOR OF CLINICAL COMPLIANCE) |
| Authorized Official Contact | 6314579145 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
125 Chubb Ave Ste 100s Lyndhurst NJ 07071-3504 Ph: () - | 125 Chubb Ave Suite 100-s Lyndhurst NJ 07071-3504 Ph: (201) 559-7600 |
| NPI Number | 1972044923 |
|---|---|
| Provider Enumeration Date | 03/10/2017 |
| Last Update Date | 10/12/2022 |
| Medicare PECOS PAC ID | 9931473139 |
|---|---|
| Medicare Enrollment ID | O20170927002286 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972044923 | NPI | - | NPPES |
| Provider Name | Jenalyn B Canullas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881777100 PECOS PAC ID: 5496791790 Enrollment ID: I20050927000047 |
| Provider Name | Joselina E Goris-hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609821909 PECOS PAC ID: 2365500964 Enrollment ID: I20081027000481 |
| Provider Name | Gwen Dodd Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427343482 PECOS PAC ID: 3072786862 Enrollment ID: I20111021000288 |
| Provider Name | Marie Y Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154670412 PECOS PAC ID: 2062661424 Enrollment ID: I20121001000158 |
| Provider Name | Richard Seides |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174717011 PECOS PAC ID: 8022255066 Enrollment ID: I20130510000046 |
| Provider Name | Natasha N Ashton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427491703 PECOS PAC ID: 2567789936 Enrollment ID: I20150324000164 |
| Provider Name | Tashia R Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427451657 PECOS PAC ID: 3577882307 Enrollment ID: I20150429001456 |
| Provider Name | Melissa Sue Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124419726 PECOS PAC ID: 2961715156 Enrollment ID: I20150716002461 |
| Provider Name | Whitney Huston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790072411 PECOS PAC ID: 6103134945 Enrollment ID: I20150929000880 |
| Provider Name | Jessica Ji-won Son |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275851834 PECOS PAC ID: 2264729292 Enrollment ID: I20160920000227 |
| Provider Name | Titilola Olayemi Oloyede |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669826053 PECOS PAC ID: 0648559955 Enrollment ID: I20161109000704 |
| Provider Name | Yanitza Acevedo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902297716 PECOS PAC ID: 8527341734 Enrollment ID: I20170214002199 |
| Provider Name | Nickesha L Ritchie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063953560 PECOS PAC ID: 7012294796 Enrollment ID: I20170505001322 |
| Provider Name | Japeth Demetria |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386018497 PECOS PAC ID: 8426316761 Enrollment ID: I20171214002722 |
| Provider Name | Olanda Dreher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144530361 PECOS PAC ID: 5496014888 Enrollment ID: I20180110000914 |
| Provider Name | Rita A Mctighe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720591712 PECOS PAC ID: 7618230616 Enrollment ID: I20180404000365 |
| Provider Name | Tracy L Anselmo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962980862 PECOS PAC ID: 7719221563 Enrollment ID: I20181204003863 |
| Provider Name | Susan Heather Lake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790255941 PECOS PAC ID: 4082953294 Enrollment ID: I20190306001848 |
| Provider Name | Binalben G Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487152120 PECOS PAC ID: 7416298120 Enrollment ID: I20190408000101 |
| Provider Name | Sandy T Clemente |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811258122 PECOS PAC ID: 5193025229 Enrollment ID: I20190627002208 |
| Provider Name | Rhoda W Kimani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003450958 PECOS PAC ID: 4082048350 Enrollment ID: I20191218002841 |
| Provider Name | Cecilia T Urquico |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013966548 PECOS PAC ID: 4789751041 Enrollment ID: I20191226000313 |
| Provider Name | Miorky Torres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851922975 PECOS PAC ID: 3971933854 Enrollment ID: I20200416000784 |
| Provider Name | Barbara Raymond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164046355 PECOS PAC ID: 4789049461 Enrollment ID: I20230502002697 |
| Provider Name | Gonzalo Olivares Maldonado |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326300807 PECOS PAC ID: 1052606233 Enrollment ID: I20230808001986 |
| Provider Name | Geralda Gelus-jules |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881950269 PECOS PAC ID: 8022463389 Enrollment ID: I20231006002227 |
| Provider Name | Karintha Holifield |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649422627 PECOS PAC ID: 1052699568 Enrollment ID: I20240930000552 |
| Provider Name | Damanjeet Chaubey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821019746 PECOS PAC ID: 7810058393 Enrollment ID: I20241122002855 |
| Provider Name | Alexandra J Renelus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245731751 PECOS PAC ID: 0749526747 Enrollment ID: I20241122003822 |
| Provider Name | Beatrice A Ochieng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821718818 PECOS PAC ID: 1355877788 Enrollment ID: I20241210000207 |
First Care Medical Group, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 750 Valley Brook Ave, Lyndhurst, NJ 07071 Phone: 201-896-0900 Fax: 201-896-2726 | |
Gisele Castelluber Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 477 Stuyvesant Ave, Lyndhurst, NJ 07071 Phone: 201-933-2333 Fax: 201-933-3885 | |
Sunny Telehealth Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 70 Ridge Rd, Lyndhurst, NJ 07071 Phone: 201-504-1400 | |
Park Avenue Medical Associates, P.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 30 Park Ave, Suite 202, Lyndhurst, NJ 07071 Phone: 201-438-5900 | |
Bhmg - United Medical Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 612 Rutherford Ave, Lyndhurst, NJ 07071 Phone: 201-460-0063 Fax: 201-460-7195 | |
Califano&gianatiempo Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 515 Prospect Pl, Lyndhurst, NJ 07071 Phone: 201-978-6479 |