| Prestige Medical & Rehabilitation Center, P.c. | |
|
80 E Ridgewood Ave Ste 4 Paramus NJ 07652-3625 | |
| (201) 265-5000 | |
| (201) 265-5003 |
| Full Name | Prestige Medical & Rehabilitation Center, P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 80 E Ridgewood Ave Ste 4, Paramus, New Jersey |
| Authorized Official Name and Position | Dana B Gellis (PRESIDENT) |
| Authorized Official Contact | 2012655000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prestige Medical & Rehabilitation Center, P.c. 80 E Ridgewood Ave Ste 4 Paramus NJ 07652-3625 Ph: (201) 265-5000 | Prestige Medical & Rehabilitation Center, P.c. 80 E Ridgewood Ave Ste 4 Paramus NJ 07652-3625 Ph: (201) 265-5000 |
| NPI Number | 1477580744 |
|---|---|
| Provider Enumeration Date | 06/26/2006 |
| Last Update Date | 05/01/2018 |
| Medicare PECOS PAC ID | 3476517442 |
|---|---|
| Medicare Enrollment ID | O20041118000773 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477580744 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25MA0726200 (New Jersey) | Primary |
| 225100000X | Physical Therapist | 40QA00873600 (New Jersey) | Secondary |
| Provider Name | Nikolai Pushnya |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1407886633 PECOS PAC ID: 9335042985 Enrollment ID: I20040130000210 |
| Provider Name | Dana B Gellis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477500577 PECOS PAC ID: 6901860956 Enrollment ID: I20041118000653 |
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