MS. KIM R MARTIN-WIDAWSKY (NPI# 1053484147) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053484147 |
| Entity Type | Individual |
| Full Name | MS. KIM R MARTIN-WIDAWSKY |
| Credential | ANPC |
| Practice Address |
77 W Maple Ave Allendale NJ 07401-1206 |
| Mailing Address |
Po Box 625 Allendale NJ 07401-0625 |
| Practice Telephone | (201) 394-3329 |
| Mailing Telephone | (201) 394-3329 |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WX0106X |
Registered Nurse Specialization: Occupational Health |
300344 | NY | Nursing Service Providers |
| N | 163WX0106X |
Registered Nurse Specialization: Occupational Health |
26NN06683300 | NJ | Nursing Service Providers |
| N | 363L00000X | Nurse Practitioner | 26NN06683300 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
300344 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | ADVANCE PRACTICE NURSE | 26NN06683300 | 01 |
| NY | RN ANP LICENSE | 300344 | 01 |
| NY | NURSE PRACTITIONER IN ADULT HEALTH | F300344-1 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 33 Liberty St, Federal Reserve Bank of Ny Medical Dept., New York, NY 100451003 | 2127205201 | 2127207775 |
| 1255 Broad St, Bloomfield, NJ 070033000 | 2013943329 |
| Street Address |
77 W MAPLE AVE |
| City | ALLENDALE |
| State | NJ |
| Zip Code | 07401-1206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134603343 | Ediltruda N Kalikawe | Counselor | 400 Crescent Court, Allendale, NJ 07401 | 2018-09-24 |
| 1114356250 | Madalina Cornelia Mares | Physical Therapist | 49 W Allendale Ave, Allendale, NJ 07401 | 2013-11-08 |
| 1992942155 | Matthew A. Rocco | Dentist | 70 W Allendale Avenue, Allendale, NJ 07401 | 2009-01-09 |
| 1366564601 | Mary Ellen M Stiehl | Counselor | 175 E Crescent Ave, Allendale, NJ 07401 | 2007-04-06 |
| 1851431530 | Lore Denver Basil | Social Worker | 33 W Orchard St, Allendale, NJ 07401 | 2007-02-08 |
| 1790823961 | Theodore A Campbell Jr. | Chiropractor | 1 Demercurio Drive, Suite #8, Allendale, NJ 07401 | 2007-02-01 |
| 1699830190 | F James Obosky Sr. | Dentist | 70 West Allendale Av, Suite C, Allendale, NJ 07401 | 2006-12-26 |
| 1457455883 | Jill E Sieverts | Marriage & Family Therapist | 70 West Allendale Avenue, Suite A, Allendale, NJ 07401 | 2006-09-07 |
| 1962427526 | Great Atlantic & Pacific Tea Company Inc | Pharmacy | 45 Demercurio Drive, Allendale, NJ 07401 | 2006-07-13 |
| 1265809370 | Acme Markets Inc | Durable Medical Equipment & Medical Supplies | 45 Demercurio Drive, Allendale, NJ 07401 | 2015-08-24 |
| Find all providers in zip 07401 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275133175 | Kristy Liekfet | Nurse Practitioner | Atlanticare Apg Palliative Care, 1925 Pacific Ave. 1st Flr, Atlantic City, NJ 08401 | 2020-10-29 |
| 1609476761 | Remya Uthup | Nurse Practitioner | 240 Main St Apt 418, Hackensack, NJ 07601-5745 | 2020-10-28 |
| 1083213524 | Joann Michelle Munoz | Nurse Practitioner | 11 Highland Pl, Ridgefield Park, NJ 07660-1203 | 2020-10-24 |
| 1669071775 | Destiny Medical Practice LLC | Nurse Practitioner | 10 Amara Ln, Westampton, NJ 08060-5753 | 2020-10-20 |
| 1912505918 | Lamercie Brasier | Nurse Practitioner | 55 Valley Way, West Orange, NJ 07052-5829 | 2020-10-12 |
| 1568069912 | Christine B Adams | Nurse Practitioner | 75 Lane Rd, Fairfield, NJ 07004-1044 | 2020-10-07 |
| 1255938361 | Maryjoy Marzan | Nurse Practitioner | Hope Tower - Jersey Shore University Medical Center, 19 Davis St 6th Floor, Neptune, NJ 07753 | 2020-10-02 |
| 1235746553 | Ellen Smith | Nurse Practitioner | 340 Airis Dr., Suite 203, Newark, NJ 07114 | 2020-09-30 |
| 1861009342 | Maria Angela Flores | Nurse Practitioner | 482 William Way N, Wyckoff, NJ 07481-1722 | 2020-09-28 |
| 1437764545 | Alison O'neill | Nurse Practitioner | 720 Monroe St Ste E407, Hoboken, NJ 07030-6356 | 2020-09-15 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.