| Pattner & Grodstein Md Pa | |
|
177 N Dean St Suite 207 Englewood NJ 07631-2533 | |
| (201) 567-0446 | |
| (201) 567-8775 |
| Full Name | Pattner & Grodstein Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 177 N Dean St, Englewood, New Jersey |
| Authorized Official Name and Position | Austin M Pattner (PRESIDENT) |
| Authorized Official Contact | 2015670446 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pattner & Grodstein Md Pa 177 N Dean St Suite 207 Englewood NJ 07631-2533 Ph: (201) 567-0446 | Pattner & Grodstein Md Pa 177 N Dean St Suite 207 Englewood NJ 07631-2533 Ph: (201) 567-0446 |
| NPI Number | 1932112950 |
|---|---|
| Provider Enumeration Date | 08/14/2006 |
| Last Update Date | 10/01/2007 |
| Medicare PECOS PAC ID | 3173591781 |
|---|---|
| Medicare Enrollment ID | O20040922000020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932112950 | NPI | - | NPPES |
| 0911607 | Medicaid | NJ | |
| 0396206 | Medicaid | NJ | |
| 0520004 | Medicaid | NJ | |
| 7449704 | Medicaid | NJ | |
| 8262608 | Medicaid | NJ | |
| 0036803 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Primary |
| Provider Name | Deborah A Fein |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1013998210 PECOS PAC ID: 2567402621 Enrollment ID: I20050509000166 |
| Provider Name | Gerald Grodstein |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1245211440 PECOS PAC ID: 5395808950 Enrollment ID: I20101129000813 |
| Provider Name | Austin Michael Pattner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639150840 PECOS PAC ID: 1658566328 Enrollment ID: I20101129000854 |
| Provider Name | Lawrence Davis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881675098 PECOS PAC ID: 4587850888 Enrollment ID: I20101129000915 |
| Provider Name | Teena Zachariah |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1477815702 PECOS PAC ID: 1759651201 Enrollment ID: I20170717002433 |
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