| Holy Name Health Physicians | |
|
718 Teaneck Rd Teaneck NJ 07666-4245 | |
| (201) 833-3000 | |
| (201) 227-6207 |
| Full Name | Holy Name Health Physicians |
|---|---|
| Speciality | Internal Medicine |
| Location | 718 Teaneck Rd, Teaneck, New Jersey |
| Authorized Official Name and Position | Patricia Beniquez Pacheco (CREDENTIALING SUPERVISOR) |
| Authorized Official Contact | 2018333599 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Holy Name Health Physicians 3 University Plz Ste 205 Hackensack NJ 07601-6208 Ph: (201) 833-3599 | Holy Name Health Physicians 718 Teaneck Rd Teaneck NJ 07666-4245 Ph: (201) 833-3000 |
| NPI Number | 1194395269 |
|---|---|
| Provider Enumeration Date | 06/30/2021 |
| Last Update Date | 05/08/2024 |
| Medicare PECOS PAC ID | 0244632909 |
|---|---|
| Medicare Enrollment ID | O20210719000165 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194395269 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Babalola O Jinadu |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770835282 PECOS PAC ID: 0749597854 Enrollment ID: I20170619000121 |
| Provider Name | Yulong Yang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013392919 PECOS PAC ID: 6709131675 Enrollment ID: I20180618000663 |
| Provider Name | Joseph I Petrsoric |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881937613 PECOS PAC ID: 3678829215 Enrollment ID: I20180711003665 |
| Provider Name | Jose E Diaz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588060586 PECOS PAC ID: 9638457583 Enrollment ID: I20210628000531 |
| Provider Name | Jeanne D Rolle |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1710474911 PECOS PAC ID: 5890043772 Enrollment ID: I20220812000338 |
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