DR. JERROLD J ELLNER (NPI# 1174736797) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174736797 |
| Entity Type | Individual |
| Full Name | DR. JERROLD J ELLNER |
| Credential | M.D. |
| Practice Address |
140 Bergen St # D Newark NJ 07103 |
| Mailing Address |
30 Bergen St Rm 1205 Newark NJ 07107-3000 |
| Practice Telephone | 9739724071 |
| Practice Fax Number | 9739723102 |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2019-01-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 242471 | MA | Allopathic & Osteopathic Physicians |
| Y | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
242471 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 8201200 | 05 | |
| MA | 110086419A | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 725 Albany Street, Shapiro 9, Suite B, Boston, MA 021182526 | 6174144290 | 6174144285 |
| Street Address |
140 BERGEN ST # D |
| City | NEWARK |
| State | NJ |
| Zip Code | 07103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841634623 | Tanzila Salim | Internal Medicine | 140 Bergen St # D, Newark, NJ 07103-2425 | 2013-04-23 |
| 1437384070 | Yingda Xie | Internal Medicine | 140 Bergen St # D, Newark, NJ 07103 | 2009-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124657077 | Yingna Liu | Student in an Organized Health Care Education/Training Program | Medical Science Building, 185 South Orange Avenue, Newark, NJ 07103 | 2020-04-03 |
| 1568029684 | Martins Akhibi | Nurse Practitioner | 178 Newton Street, Newark, NJ 07103 | 2019-05-23 |
| 1972168482 | Newark Renaissance House, Inc | Rehabilitation, Substance Use Disorder Unit | 50-56 Norfolk Street, Newark, NJ 07103 | 2019-05-09 |
| 1346709235 | Ian Wang Yu | Student in an Organized Health Care Education/Training Program | 185 South Orange Ave., Medical Science Building, Room I-506, Newark, NJ 07103 | 2019-03-19 |
| 1437648417 | Stephen Vanbeek | Internal Medicine | 185 S Orange Ave Rm 547, Newark, NJ 07103 | 2018-05-06 |
| 1073019444 | Geoffrey Alexander Talis | Student in an Organized Health Care Education/Training Program | 183 S. Orange Avenue, Level E, Room 1452, Newark, NJ 07103 | 2018-04-03 |
| 1285139907 | Thomas Georg Bachmann | Student in an Organized Health Care Education/Training Program | 185 South Orange Ave, Medical Science Building, G-538, Newark, NJ 07103 | 2018-03-26 |
| 1154825289 | Shammi A Patel | Student in an Organized Health Care Education/Training Program | 185 S Orange Ave # Msbg594, Newark, NJ 07103 | 2018-03-22 |
| 1982122545 | North Jersey Aids Alliance | Clinic/Center | 393 Central Avenue C/o Corey Destefano, Newark, NJ 07103 | 2017-09-05 |
| 1134655533 | Yasmin N Abedin | Student in an Organized Health Care Education/Training Program | 185 South Orange Ave, Msb E-506, Rutgers, New Jersey Medical School, Newark, NJ 07103 | 2017-05-04 |
| Find all providers in zip 07103 | ||||
| Taxonomy Code | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295006948 | Byungwoo Choi | Internal Medicine | 537 Stanton Christiana Rd Ste 201, Newark, DE 19713-2148 | 2012-01-25 |
| 1174802557 | Gilda Bontempo | Internal Medicine | 185 S Orange Ave Msb I-689, Newark, NJ 07103-2757 | 2011-08-16 |
| 1942456272 | Melinda Sheron Brown | Internal Medicine | St James Health Center, 228 Lafayette Street, Newark, NJ 07105 | 2008-08-18 |
| 1902967508 | Alfred E Bacon IIi | Internal Medicine | 78 Omega Dr, Bldg C, Newark, DE 19713-2064 | 2006-12-13 |
| 1912068529 | Stephanie A Lee | Internal Medicine | 78 Omega Dr Bldg C, Newark, DE 19713-2064 | 2006-12-13 |
| 1811942766 | St Michael Infectious Disease Associates | Internal Medicine | 265 Dr Martin Luther King Jr Blvd, Newark, NJ 07102-2012 | 2006-05-22 |
| 1922497635 | Tilly Varughese | Internal Medicine | 185 S Orange Ave, Newark, NJ 07103-2757 | 2015-01-19 |
| 1417379983 | Maria Elaine Szabela | Internal Medicine | 111 Central Ave, Newark, NJ 07102-1909 | 2014-01-17 |
| 1841634623 | Tanzila Salim | Internal Medicine | 140 Bergen St # D, Newark, NJ 07103-2425 | 2013-04-23 |
| 1487914834 | Kristen Leigh Facciolo | Internal Medicine | 4755 Ogletown Stanton Rd, Newark, DE 19718-0001 | 2012-05-19 |
| Find all providers in NEWARK | ||||
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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.