MR. BRIAN W. BOOCKOFF (NPI# 1326312430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326312430 |
| Entity Type | Individual |
| Full Name | MR. BRIAN W. BOOCKOFF |
| Credential | PA-C |
| Practice Address |
414 Tatum St Woodbury NJ 08096-3499 |
| Mailing Address |
500 Grove St Suite 100 Haddon Heights NJ 08035-1761 |
| Practice Telephone | 8568483880 |
| Practice Fax Number | 8568484895 |
| Mailing Telephone | 8567969200 |
| Mailing Fax Number | 8567969397 |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2014-04-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
25MP00280500 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
25MP00280500 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
414 TATUM ST |
| City | WOODBURY |
| State | NJ |
| Zip Code | 08096-3499 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356348551 | Thomas P Obade | Specialist | 414 Tatum St, Woodbury, NJ 08096-3499 | 2005-07-01 |
| 1841689262 | Shaun Rowe | Physician Assistant | 414 Tatum St, Woodbury, NJ 08096-3499 | 2015-01-22 |
| 1659779601 | Salvatore Spitalieri Jr. | Specialist/Technologist | 414 Tatum St, Woodbury, NJ 08096-3499 | 2014-12-08 |
| 1134370166 | Nathan Holmes | Family Medicine | 414 Tatum St, Woodbury, NJ 08096-3499 | 2008-10-08 |
| 1396943619 | Steven Frey | Orthopaedic Surgery | 414 Tatum St, Woodbury, NJ 08096-3499 | 2007-07-08 |
| 1497888259 | Michael Charles Senisch | Physician Assistant | 414 Tatum St, Woodbury, NJ 08096-3499 | 2007-03-13 |
| 1275574667 | Advanced Orthopaedic Centers Pa | Orthopaedic Surgery | 414 Tatum St, Woodbury, NJ 08096-3499 | 2006-06-09 |
| 1013979830 | Erik John Heller | Physical Therapist | 414 Tatum St, Woodbury, NJ 08096-3499 | 2006-04-05 |
| 1033117346 | Bruce A Monaghan | Specialist | 414 Tatum St, Woodbury, NJ 08096-3499 | 2005-07-11 |
| 1598762031 | Frederick George | Specialist | 414 Tatum St, Woodbury, NJ 08096-3499 | 2005-06-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780226043 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1460 Cooper Street, Deptford, NJ 08096 | 2019-10-08 |
| 1730652058 | Robert Crawford Counseling & Consultation, LLC | Counselor | Robert Crawford Counseling & Consultation, LLC, 44 Cooper Street, Suite 208, Woodbury, NJ 08096 | 2019-01-09 |
| 1902381171 | Services To Overcome Drug Abuse Among Teenagers, Inc. | Clinic/Center | 124 N Broad Street, Woodbury, NJ 08096 | 2018-10-03 |
| 1225518715 | Michael West | Pharmacist | 631 West Mantua Ave, Woodbury, NJ 08096 | 2018-08-15 |
| 1053807891 | Standing Ground Counseling, LLC | Clinic/Center | 44 Cooper Street, Suite 104, Woodbury, NJ 08096 | 2018-07-05 |
| 1376054536 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 40 Hessian Avenue, Woodbury, NJ 08096 | 2017-10-16 |
| 1881105021 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1154 Bennett Drive, Deptford, NJ 08096 | 2017-10-16 |
| 1215448469 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7 North Evergreen Avenue, Woodbury, NJ 08096 | 2017-10-16 |
| 1801307137 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6 North Drexel Street, Woodbury, NJ 08096 | 2017-10-13 |
| 1295253847 | Sara Alven | Social Worker | 1 Lupton Avenue, Woodbury, NJ 08096 | 2017-09-05 |
| Find all providers in zip 08096 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902041536 | James D Fulginiti | Physician Assistant | 603 North Broad Steet, Craig H. Rosen, M.d.,p.a., Woodbury, NJ 08096 | 2008-12-11 |
| 1043270952 | David Preston Law | Physician Assistant | 2090 Woodwinds Dr Ste 200, Woodbury, MN 55125-2522 | 2006-03-24 |
| 1720057334 | Mary C Aschenbrener | Physician Assistant | 215 Radio Dr Ste 100, Woodbury, MN 55125-5817 | 2006-03-16 |
| 1063057628 | Margaret Faust | Physician Assistant | 2090 Woodwinds Dr Ste 200, Woodbury, MN 55125-2522 | 2019-11-07 |
| 1306404835 | Madison Lee Haus | Physician Assistant | 2090 Woodwinds Dr Ste 200, Woodbury, MN 55125-2522 | 2019-05-30 |
| 1740844794 | Maren Fiscus | Physician Assistant | 2090 Woodwinds Dr Ste 200, Woodbury, MN 55125-2522 | 2019-04-25 |
| 1962965848 | Molly Michelle Mullee | Physician Assistant | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2019-04-09 |
| 1013458009 | Abby Mohr | Physician Assistant | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2017-03-10 |
| 1497135172 | Natasha Harr | Physician Assistant | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2015-06-08 |
| 1851795827 | Megan Anne Heck | Physician Assistant | 2090 Woodwinds Dr, Woodbury, MN 55125-4925 | 2014-10-20 |
| Find all providers in WOODBURY | ||||
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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.