| Simon Fensterszaub Do Nj Pc | |
|
101 Chase Ave Ste 105 Lakewood NJ 08701-4761 | |
| (212) 201-1252 | |
| Not Available |
| Full Name | Simon Fensterszaub Do Nj Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 101 Chase Ave Ste 105, Lakewood, New Jersey |
| Authorized Official Name and Position | Simon Fensterszaub (PRESIDENT) |
| Authorized Official Contact | 2127346621 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Simon Fensterszaub Do Nj Pc 101 Chase Ave Ste 105 Lakewood NJ 08701-4761 Ph: (718) 964-6161 | Simon Fensterszaub Do Nj Pc 101 Chase Ave Ste 105 Lakewood NJ 08701-4761 Ph: (212) 201-1252 |
| NPI Number | 1417681008 |
|---|---|
| Provider Enumeration Date | 07/11/2022 |
| Last Update Date | 05/22/2023 |
| Medicare PECOS PAC ID | 6608258546 |
|---|---|
| Medicare Enrollment ID | O20220809001715 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417681008 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Imee Dhir |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316304645 PECOS PAC ID: 2860799327 Enrollment ID: I20160328002018 |
| Provider Name | Emily Michelle Ramiro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316483852 PECOS PAC ID: 5799048757 Enrollment ID: I20180405000162 |
| Provider Name | Carlos E Lozano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699324913 PECOS PAC ID: 2961734694 Enrollment ID: I20191030002340 |
| Provider Name | Simon Fensterszaub |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003077322 PECOS PAC ID: 5890970230 Enrollment ID: I20200108001714 |
| Provider Name | Leilani Tandoc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538621537 PECOS PAC ID: 7517290471 Enrollment ID: I20240322000242 |
| Provider Name | Aharon Feldman |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1235584962 PECOS PAC ID: 8921379249 Enrollment ID: I20240604000145 |
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