TRI COUNTY MEDICAL ASSOCIATE PC (NPI# 1194709253) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194709253 |
| Entity Type | Organization |
| Organization Name | TRI COUNTY MEDICAL ASSOCIATE PC |
| Practice Address |
20 Broadway Woodridge NY 12789-0546 |
| Mailing Address |
Po Box 546 20 Broadway Woodridge NY 12789-0546 |
| Practice Telephone | 8454346333 |
| Practice Fax Number | 8454342346 |
| Mailing Telephone | 8454346333 |
| Mailing Fax Number | 8454342346 |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2007-09-28 |
| Authorized Official Name | DR. RENU S JERATH (DOCTOR OWNER) |
| Authorized Official Telephone | 8454346333 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 153068-2 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
20 BROADWAY |
| City | WOODRIDGE |
| State | NY |
| Zip Code | 12789-0546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609355882 | Charles Robinson Jr. | Non-emergency Medical Transport (VAN) | 1220 Glenn Wild Rd, Woodridge, NY 12789 | 2018-08-09 |
| 1093263998 | Oda Primary Health Care Network, Inc. | Clinic/Center | 6 Dairyland Rd, Woodridge, NY 12789 | 2016-09-20 |
| 1578994141 | Mark A York II | Licensed Practical Nurse | 34-36 Broadway, Apt. 104, Woodridge, NY 12789 | 2013-12-09 |
| 1740351832 | David S Drew | Dentist | 9 Highland Ave, Woodridge, NY 12789 | 2006-11-13 |
| 1881825941 | Krieger Medical | Clinic/Center | 13 Fourth St, Woodridge, NY 12789-0034 | 2009-08-06 |
| 1356585780 | Charles Howard Kornblau | Internal Medicine | 2 First Street, Woodridge, NY 12789-0101 | 2009-04-29 |
| 1679877914 | Dorothy Novogrodsky | Specialist | 223 Dairyland Rd., Woodridge, NY 12789-0153 | 2010-12-30 |
| 1487134011 | Jeweliana B Trujillo | Licensed Practical Nurse | 22 Dairyland Rd Ext, Woodridge, NY 12789-1278 | 2018-08-14 |
| 1881204006 | Kelly Spear | Social Worker | 10 Alpine Dr # 1003, Woodridge, NY 12789-5800 | 2020-08-03 |
| 1184027294 | Onyinye Amakom | Registered Nurse | 3 Edelweiss Dr, Woodridge, NY 12789-5806 | 2014-10-02 |
| Find all providers in zip 12789 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609908383 | Renu Gupta | Family Medicine | 1221 Longford St, Woodridge, IL 60517-7748 | 2007-03-09 |
| 1437185980 | Kirtikumar P Talsania | Family Medicine | 5 Yellow Star Ct, Woodridge, IL 60517-1702 | 2006-06-25 |
| 1508833500 | Glenn Nelson | Family Medicine | 7409 Woodridge Dr, Woodridge, IL 60517-2249 | 2006-03-08 |
| 1366416380 | Jonathan David Meek | Family Medicine | 2363 63rd St, Woodridge, IL 60517-1369 | 2006-02-15 |
| 1427439462 | Helena Ann Keag | Family Medicine | 2363 63rd St, Woodridge, IL 60517-1369 | 2015-06-16 |
| 1316334816 | Lydia S Bruce | Family Medicine | 2363 63rd St, Woodridge, IL 60517-1369 | 2015-04-22 |
| 1982041471 | Laura Marie Norman | Family Medicine | 2363 63rd St, Woodridge, IL 60517-1369 | 2013-05-24 |
| 1528309879 | Elita Lois Hohner | Family Medicine | 2363 63rd St, Woodridge, IL 60517-1369 | 2013-03-12 |
| 1790046860 | Sonali Bhatnagar | Family Medicine | 2363 63rd St, Woodridge, IL 60517-1369 | 2012-06-05 |
| 1194952614 | Chandra Sharma | Family Medicine | 7530 Woodward Ave, Woodridge, IL 60517-3100 | 2009-06-11 |
| Find all providers in WOODRIDGE | ||||
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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.