INTEGRATIVE FUNCTIONAL MEDICINE ASSOCIATES LLC (NPI# 1063739829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063739829 |
| Entity Type | Organization |
| Organization Name | INTEGRATIVE FUNCTIONAL MEDICINE ASSOCIATES LLC |
| Practice Address |
292 Bloomfield Ave 2nd Floor Montclair NJ 07042-3624 |
| Mailing Address |
41 Watchung Plz Suite 345 Montclair NJ 07042-4117 |
| Practice Telephone | 9739288909 |
| Practice Fax Number | 2019678425 |
| Mailing Telephone | 2019678425 |
| Mailing Fax Number | 2019678443 |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2010-05-03 |
| Authorized Official Name | JODI THOMAS (MD) |
| Authorized Official Telephone | 2019678425 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P0004X |
Physical Medicine & Rehabilitation Specialization: Spinal Cord Injury Medicine |
25MA07295900 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 005466 | 05 |
| Street Address |
292 BLOOMFIELD AVE 2ND FLOOR |
| City | MONTCLAIR |
| State | NJ |
| Zip Code | 07042-3624 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649295932 | Noel C Nowicki | Internal Medicine | 292 Bloomfield Ave, Montclair, NJ 07042-3624 | 2006-07-13 |
| 1831521558 | Rachel H Perlman | Social Worker | 292 Bloomfield Ave, Floor 2, Montclair, NJ 07042-3624 | 2013-08-05 |
| 1316248404 | Gretchen M Silver | Chiropractor | 292 Bloomfield Ave, Suite 205, Montclair, NJ 07042-3624 | 2010-11-05 |
| 1578741815 | Jeremy Steiner | Acupuncturist | 292 Bloomfield Ave, Montclair, NJ 07042-3624 | 2008-02-08 |
| 1396832051 | Noel C Nowicki Md Pa | Internal Medicine | 292 Bloomfield Ave, Montclair, NJ 07042-3624 | 2006-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003451261 | Montclair Art Museum | Voluntary or Charitable | 3 South Mountain Avenue, Montclair, NJ 07042 | 2019-11-12 |
| 1740847797 | Magnify In-home Eyecare | Optometrist | Little Nursing Home, 71 Christopher Street, Montclair, NJ 07042 | 2019-05-24 |
| 1326539073 | Wendy C Kaplan | Social Worker | 460 Bloomfield Ave Suite 209, Montclair, NJ 07042 | 2018-05-29 |
| 1538666342 | Mary Elizabeth Mcgaughan | Psychologist | 239 Grove Street, Montclair, NJ 07042 | 2018-04-09 |
| 1023546777 | Alexander Scott Fisher | Dentist | 39 S Fullerton Ave Fl 2, Montclair, NJ 07042 | 2017-05-25 |
| 1942754825 | Kaity Rodriguez | Social Worker | 105 Grove St., Montclair, NJ 07042 | 2016-08-09 |
| 1144678889 | Melissa Cardinal | Nurse Practitioner | 36 Valley Road, 529, Montclair, NJ 07042 | 2016-06-02 |
| 1528413655 | Bellapianta Orthopaedics and Sports Medicine LLC | Orthopaedic Surgery | 1 Bay Avenue, Harries Pavilion, Suite 1, Montclair, NJ 07042 | 2016-04-26 |
| 1740647643 | Wendalyn Leona Browne | Massage Therapist | 37 Watchung Plaza, 2l, Montclair, NJ 07042 | 2016-01-22 |
| 1891168670 | Patience Moore | Social Worker | 460 Bloomfield Ave Ste 306, Montclair, NJ 07042 | 2015-11-03 |
| Find all providers in zip 07042 | ||||
| Taxonomy Code | 2081P0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Spinal Cord Injury Medicine |
| A physician who addresses the prevention, diagnosis, treatment and management of traumatic spinal cord injury and non-traumatic etiologies of spinal cord dysfunction by working in an interdisciplinary manner. Care is provided to patients of all ages on a lifelong basis and covers related medical, physical, psychological and vocational disabilities and complications. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. ACGME Accredited Residency Program Requirements: 1 year of training with 3-5 years in relevant specialty for a total of 4-6 years. ABMS Approved Subspecialty Certificate: (Physical Medicine and Rehabilitation) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073567095 | Regional Orthopedic Professional Association | Physical Medicine & Rehabilitation | 499 Cooper Landing Rd, Cherry Hill, NJ 08002 | 2006-05-22 |
| 1235119686 | Susan V Garstang | Physical Medicine & Rehabilitation | 30 Bergen St, Admc 101, Newark, NJ 07107-3000 | 2006-01-20 |
| 1336485630 | Monica Mehta Md | Physical Medicine & Rehabilitation | 191 Palisade Ave, Jersey City, NJ 07306-1112 | 2012-12-14 |
| 1962731000 | Trevor Anthony Justin Dyson-hudson | Physical Medicine & Rehabilitation | 1199 Pleasant Valley Way, Kessler Foundation Research Center, West Orange, NJ 07052-1424 | 2009-12-21 |
| 1548421910 | Amanda Farag | Physical Medicine & Rehabilitation | 385 Tremont Ave, (561/128), East Orange, NJ 07018-1023 | 2008-06-19 |
| 1811098437 | Carol M Gibson-gill | Physical Medicine & Rehabilitation | 385 Tremont Ave, East Orange, NJ 07018 | 2006-09-26 |
| 1043274350 | Kurt Florian P Thomas | Physical Medicine & Rehabilitation | 30 Prospect Ave, Neuroscience Institute, Hackensackumc, Hackensack, NJ 07601-1915 | 2006-04-13 |
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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.