REBECCA A HERITAGE (NPI# 1356615835) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356615835 |
| Entity Type | Individual |
| Full Name | REBECCA A HERITAGE |
| Credential | MMSC, PA-C |
| Practice Address |
17 W Red Bank Ave Suite 207 Woodbury NJ 08096-1630 |
| Practice Telephone | 8568450664 |
| Practice Fax Number | 8568457602 |
| Mailing Telephone | 8568450664 |
| Mailing Fax Number | 8568457602 |
| Enumeration Date | 2012-03-01 |
| Last Update Date | 2015-06-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 0010-03424 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
25MP00318300 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
0010-03424 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
17 W RED BANK AVE SUITE 207 |
| City | WOODBURY |
| State | NJ |
| Zip Code | 08096-1630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255338216 | Oncology and Hematology Associates | Internal Medicine | 17 W Red Bank Ave, Suite 101, Woodbury, NJ 08096-1630 | 2005-07-06 |
| 1114479607 | Bethany Gilbert | Physician Assistant | 17 W Red Bank Ave, #203, Woodbury, NJ 08096-1630 | 2016-10-31 |
| 1669893889 | General Vascular Surgical Specialists LLC | Surgery | 17 W Red Bank Ave, Suite 203, Woodbury, NJ 08096-1630 | 2013-12-16 |
| 1093143406 | Advocare, LLC | Surgery | 17 W Red Bank Ave, Suite 203, Woodbury, NJ 08096-1630 | 2013-10-22 |
| 1417220310 | Tri-county Health Connections PC | Psychiatry & Neurology | 17 W Red Bank Ave, Suite 204, Woodbury, NJ 08096-1630 | 2012-02-23 |
| 1295005031 | Tri-county Cardiovascular Services, PC | Internal Medicine | 17 W Red Bank Ave, Suite 306, Woodbury, NJ 08096-1630 | 2012-01-11 |
| 1285889220 | Marcia A Skowron Scharle | Nurse Practitioner | 17 W Red Bank Ave, Suite 306, Woodbury, NJ 08096-1630 | 2008-11-18 |
| 1487816344 | Shaila Bokkala Pinninti | Specialist | 17 W Red Bank Ave, Ste 204, Woodbury, NJ 08096 | 2008-07-01 |
| 1508041864 | General Vascular Surgical Associates of South Jersey, P.a. | Surgery | 17 W Red Bank Ave, Suite 203, Woodbury, NJ 08096-1630 | 2008-01-07 |
| 1043499825 | Michael J Denner Md Pa | Psychiatry & Neurology | 17 W Red Bank Ave, Ste 204, Woodbury, NJ 08096 | 2007-10-30 |
| 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 | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013496892 | Daniel Louis Fazzino | Physician Assistant | 76 Barnhill Rd, Woodbury, CT 06798-2219 | 2018-08-12 |
| 1871789123 | Alissa Paul | Physician Assistant | 449 Commerce Dr, Woodbury, MN 55125-4872 | 2007-09-20 |
| 1457460743 | Anthony F Orlando | Physician Assistant | 608 N Broad St, Suite 100, Woodbury, NJ 08096-1794 | 2006-08-30 |
| 1992746242 | Susan Tamagni | Physician Assistant | 159 S Broad St, Woodbury, NJ 08096-2410 | 2006-06-09 |
| 1437523248 | Abigail House Tierney | Physician Assistant | 1875 Woodwinds Dr, Woodbury, MN 55125-2298 | 2015-11-17 |
| 1396149910 | Matthew Voit | Physician Assistant | 509 N Broad St, Woodbury, NJ 08096-1617 | 2014-10-09 |
| 1588086821 | Krystina Zeliff | Physician Assistant | 875 Mantua Pike, Woodbury, NJ 08096 | 2014-01-06 |
| 1326312430 | Brian W. Boockoff | Physician Assistant | 414 Tatum St, Woodbury, NJ 08096-3499 | 2012-03-07 |
| 1790068989 | Leslie Ann Davis | Physician Assistant | 45 Crossways Park Dr W, Woodbury, NY 11797-2037 | 2011-09-23 |
| 1467733816 | Andrea M Bolesta | Physician Assistant | 509 N Broad St, Woodbury, NJ 08096-1617 | 2011-08-30 |
| 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.