| Hackensack Nj Medical Group Pc | |
|
92 Summit Ave Hackensack NJ 07601-1263 | |
| (201) 342-0066 | |
| (201) 342-0079 |
| Full Name | Hackensack Nj Medical Group Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 92 Summit Ave, Hackensack, New Jersey |
| Authorized Official Name and Position | Ehab F Ibrahim (CEO) |
| Authorized Official Contact | 2013420066 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hackensack Nj Medical Group Pc 92 Summit Ave Hackensack NJ 07601-1263 Ph: (201) 342-0066 | Hackensack Nj Medical Group Pc 92 Summit Ave Hackensack NJ 07601-1263 Ph: (201) 342-0066 |
| NPI Number | 1912151135 |
|---|---|
| Provider Enumeration Date | 11/14/2008 |
| Last Update Date | 08/31/2015 |
| Medicare PECOS PAC ID | 2769539410 |
|---|---|
| Medicare Enrollment ID | O20090415000195 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912151135 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25MA08461900 (New Jersey) | Primary |
| Provider Name | Reyhan Berkel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265630180 PECOS PAC ID: 0648457366 Enrollment ID: I20110607000264 |
| Provider Name | Eun Choi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700140217 PECOS PAC ID: 1658522651 Enrollment ID: I20121126000396 |
| Provider Name | Roman S Prager |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568789634 PECOS PAC ID: 0143464024 Enrollment ID: I20140919000141 |
| Provider Name | Hussain M Manji |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760747836 PECOS PAC ID: 4880901537 Enrollment ID: I20150914001828 |
| Provider Name | Veronica Roupenian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518410349 PECOS PAC ID: 3476835877 Enrollment ID: I20170119001736 |
| Provider Name | Carol Maye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659720878 PECOS PAC ID: 4880978741 Enrollment ID: I20170222000190 |
| Provider Name | Diana V Araque |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518493642 PECOS PAC ID: 0446522171 Enrollment ID: I20170816000040 |
| Provider Name | Shirley Carlos-cu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497151476 PECOS PAC ID: 7719226372 Enrollment ID: I20190227000900 |
| Provider Name | Krysten Wondrack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508324575 PECOS PAC ID: 3173856168 Enrollment ID: I20190606000238 |
| Provider Name | Cherion J Fullerton Coley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851810832 PECOS PAC ID: 4385069343 Enrollment ID: I20200806001168 |
| Provider Name | Mark Daco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184159766 PECOS PAC ID: 3173880291 Enrollment ID: I20201229000029 |
| Provider Name | Eulalia Leon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093352510 PECOS PAC ID: 2567875107 Enrollment ID: I20201229000101 |
| Provider Name | Shoshanah Ruth Haricha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538605456 PECOS PAC ID: 8628482882 Enrollment ID: I20210128002827 |
| Provider Name | Maya Moreno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346830635 PECOS PAC ID: 7911308903 Enrollment ID: I20210628003635 |
| Provider Name | Pamela Bray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073284774 PECOS PAC ID: 8426448911 Enrollment ID: I20211123001992 |
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Nj Docs Progressive Medical Services Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 560 Hudson St Ste 301, Hackensack, NJ 07601 Phone: 201-641-2125 Fax: 212-888-6024 | |
David P. Bleeker Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 211 Essex St, Suite 401, Hackensack, NJ 07601 Phone: 201-487-1711 Fax: 201-487-3377 | |
Vault Medical Services Of New Jersey Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 211 Essex St Ste 406, Hackensack, NJ 07601 Phone: 929-388-1551 | |
Mina Shaker Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 38 Summit Ave, Hackensack, NJ 07601 Phone: 201-343-6360 | |
North Jersey Internal Medicine Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 92 Summit Ave, Hackensack, NJ 07601 Phone: 201-342-0066 Fax: 201-342-0079 |