NOEL WIEDERHORN (NPI# 1093716359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093716359 |
| Entity Type | Individual |
| Full Name | NOEL WIEDERHORN |
| Credential | MD |
| Practice Address |
43 Yawpo Ave Oakland NJ 07436-2714 |
| Mailing Address |
870 Palisade Ave Ste 204 Teaneck NJ 07666-3419 |
| Practice Telephone | 2014050500 |
| Practice Fax Number | 2013375585 |
| Mailing Telephone | 2019281093 |
| Mailing Fax Number | 2019280842 |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2013-01-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 25MA02569900 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 1414801 | 05 |
| Street Address |
43 YAWPO AVE |
| City | OAKLAND |
| State | NJ |
| Zip Code | 07436-2714 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407492879 | Monika K Niemiec | Nurse Practitioner | 43 Yawpo Ave, Oakland, NJ 07436-2714 | 2019-11-20 |
| 1548802739 | Shannon Morgan Linde | Nurse Practitioner | 43 Yawpo Ave, Oakland, NJ 07436-2714 | 2019-10-09 |
| 1144705328 | Kajal Gandhi | Internal Medicine | 43 Yawpo Ave, Oakland, NJ 07436-2714 | 2018-10-03 |
| 1346766094 | Sylvia Bucharowski | Nurse Practitioner | 43 Yawpo Ave, Oakland, NJ 07436-2714 | 2017-08-15 |
| 1215390083 | Taylor Shaker | Family Medicine | 43 Yawpo Ave, Oakland, NJ 07436-2714 | 2016-03-30 |
| 1669634333 | Perry Rogers Ricci | Chiropractor | 43 Yawpo Ave, Suite 6, Oakland, NJ 07436-2714 | 2008-06-25 |
| 1154502045 | John Hyung-il Lee | Emergency Medicine | 43 Yawpo Ave, Ste 2, Oakland, NJ 07436-2717 | 2007-11-19 |
| 1962625210 | Clayton Irving Bridges Jr. | Physician Assistant | 43 Yawpo Ave, Suite 3, Oakland, NJ 07436-2714 | 2007-04-11 |
| 1780734962 | Benjamin R Dispenziere | Obstetrics & Gynecology | 43 Yawpo Ave, Suite 4, Oakland, NJ 07436-2714 | 2007-01-11 |
| 1689738890 | Chong Yol Baik | Dentist | 43 Yawpo Ave, Suite 5, Oakland, NJ 07436 | 2006-12-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376065680 | Jade Chinesse West | Occupational Therapy Assistant | 21 Oswego Ave, Oakland, NJ 07436 | 2017-07-10 |
| 1932521101 | Joyce Thomas | Nurse Practitioner | 14 Post Rd., Oakland, NJ 07436 | 2014-01-07 |
| 1770849739 | James A Hertel | Pharmacist | 373 Ramapo Valley Road, Oakland, NJ 07436 | 2012-04-04 |
| 1841520616 | Megan E Brooks | Physical Therapist | 100 Bauer Drive, Oakland, NJ 07436 | 2009-12-30 |
| 1669621231 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 409 Ramapo Valley Rd, Oakland, NJ 07436 | 2008-09-18 |
| 1265691190 | Donna J Lombardi-goldfus | Pediatrics | 50 Overlook Ridge, Oakland, NJ 07436 | 2008-06-05 |
| 1962547836 | Marvin Lagstein D M D P A | Dentist | 9 Post Road, Suite M1a Longhill Medical Dental Center, Oakland, NJ 07436 | 2007-02-20 |
| 1275677304 | James Joseph Scillieri | Dentist | 19 Yawpo Ave., Oakland, NJ 07436 | 2007-02-20 |
| 1528125036 | Steven William Kennelly | Specialist/Technologist | Giants Stadium, East Rutherford, NJ 07436 | 2007-01-03 |
| 1306955042 | Maurice M Maccario | Oral & Maxillofacial Surgery | 180 Ramapo Valley Road, Oakland, NJ 07436 | 2006-08-29 |
| Find all providers in zip 07436 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063831386 | Ron Yalon | Pediatrics | 469 51st St, Oakland, CA 94609-2143 | 2014-04-15 |
| 1801136262 | Anthony S Raimo | Pediatrics | 645 Ramapo Valley Rd, Oakland, NJ 07436-2813 | 2013-02-21 |
| 1326314816 | Darrow Debs Deluca | Pediatrics | 747 52nd Street, Room 201, Pediatric Multispecialty Medical Group, Oakland, CA 94609-1809 | 2012-03-28 |
| 1366760175 | Lynne N Rosen | Pediatrics | 3451 East 12th St., Oakland, CA 94601-3425 | 2010-05-04 |
| 1568698090 | Juan Raul Gutierrez | Pediatrics | 1030 International Ave., Oakland, CA 94606-3730 | 2009-06-10 |
| 1265691190 | Donna J Lombardi-goldfus | Pediatrics | 50 Overlook Ridge, Oakland, NJ 07436 | 2008-06-05 |
| 1578721551 | Josephine A Roen | Pediatrics | 125 2nd St Apt 411, Oakland, CA 94607-4565 | 2008-05-27 |
| 1124294665 | Omid Gheysar | Pediatrics | 1800 Harrison Street 7th Street, Oakland, CA 94612-3429 | 2008-05-05 |
| 1336312891 | Lisa Meredith Siskind | Pediatrics | 3505 Broadway Fl 6, Oakland, CA 94611-5714 | 2008-04-04 |
| 1205027760 | Lisa Ann B Michaels | Pediatrics | 11 E Oak St, Oakland, NJ 07436-2721 | 2007-08-08 |
| Find all providers in OAKLAND | ||||
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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.