CENTRAL AVENUE PROFESSIONAL SERVICES, PC (NPI# 1447649694) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447649694 |
| Entity Type | Organization |
| Organization Name | CENTRAL AVENUE PROFESSIONAL SERVICES, PC |
| Practice Address |
111 Central Ave Newark NJ 07102-1909 |
| Practice Telephone | 9738775300 |
| Practice Fax Number | 9738775317 |
| Mailing Telephone | 9738775300 |
| Mailing Fax Number | 9738775317 |
| Enumeration Date | 2015-01-12 |
| Last Update Date | 2015-01-12 |
| Authorized Official Name | DR. NADINE PAPPAS (DIRECTOR) |
| Authorized Official Telephone | 9738775300 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
111 CENTRAL AVE |
| City | NEWARK |
| State | NJ |
| Zip Code | 07102-1909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780687806 | Sandhya R Makkapati | Specialist | 111 Central Ave, Newark, NJ 07102-1909 | 2005-05-23 |
| 1740892496 | Stella Monday Wangai | Nurse Practitioner | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-22 |
| 1144832932 | Sonya Wali | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-21 |
| 1023620358 | Chrystina Mildred Kiwan | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-18 |
| 1518579838 | Alicia Kovach | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-18 |
| 1861003659 | Riyashat Kazmi | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-13 |
| 1114537610 | Kalee Larsen | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-09 |
| 1215547567 | Nirav Patel | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-02 |
| 1720697238 | Sneha Bijoy | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-07-30 |
| 1407465891 | Ruhma Ali | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-07-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487253779 | Integrity, Inc | Clinic/Center | 1091-1093 Broad Street, Newark, NJ 07102 | 2020-10-19 |
| 1881292720 | Oluwaseun Ademulegun | Pharmacist | 1084 Broad Street, Newark, Newark, NJ 07102 | 2020-10-13 |
| 1679042295 | Henry Paul Grayner | Specialist/Technologist | 100 Lock St, Newark, NJ 07102 | 2018-11-14 |
| 1548736838 | Integrity, Inc | Substance Abuse Rehabilitation Facility | 101 Lincoln Park, 2nd Floor, Newark, NJ 07102 | 2018-10-15 |
| 1962981407 | Crystal Kay-baune Mccown | Social Worker | 130 Orange St, Newark, NJ 07102 | 2018-08-07 |
| 1053808865 | Nubi Consultants Corp. Dba Aplus Home Care | Physical Therapist | 11 Franklin Street, 11 Franklin Street, Newark, NJ 07102 | 2018-04-17 |
| 1396249264 | Integrity, Inc | Substance Abuse Rehabilitation Facility | 49 Lincoln Park, Newark, NJ 07102 | 2018-03-23 |
| 1568960896 | Saint James Health Inc | Clinic/Center | 36 Halsey Street, Newark, NJ 07102 | 2018-02-01 |
| 1992216527 | Metropolitan Center for Human Services | Psychologist | 520 Dr. Martin Luther King, Jr. Boulevard, Newark, NJ 07102 | 2017-10-23 |
| 1467974949 | Ahmad Mohammad Tawfiq Damati | Student in an Organized Health Care Education/Training Program | 123 University Ave, Newark, Nj 07102, Newark, NJ 07102 | 2017-07-17 |
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| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| 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 |
|---|---|---|---|---|
| 1053935825 | Garrett Evan Benham | Internal Medicine | 7166 Alexandra Dr Apt 6, Newark, DE 19702-8142 | 2020-06-07 |
| 1427277821 | Amee Shirish Patrawalla | Internal Medicine | 150 Bergen Street, Room I-354, Umdnj-nj Medical School Pulmonary Critical Care, Newark, NJ 07103 | 2007-04-24 |
| 1376627141 | Richmar Medical Associates | Internal Medicine | 268-306 Dr. M.l.k. Blvd., Newark, NJ 07102 | 2006-10-25 |
| 1588745772 | Marc Adelman | Internal Medicine | 268-306 Martin Luther King Blvd, Newark, NJ 07102 | 2006-10-17 |
| 1538118070 | Ismael A. Matus | Internal Medicine | 4745 Ogletown-stanton Road, Suite 220, Newark, DE 19713-2074 | 2006-05-10 |
| 1376515023 | Steven Y Chang | Internal Medicine | 150 Bergen St # Uh I-354, Umdnj - Micu Director, Newark, NJ 07103-2496 | 2006-02-06 |
| 1679983605 | Yazan Abdeen | Internal Medicine | 111 Central Ave, Newark, NJ 07102-1909 | 2014-04-29 |
| 1992047294 | John Arek Kileci | Internal Medicine | 150 Bergen St, Uh-i248, Newark, NJ 07103-2496 | 2013-03-25 |
| 1255618070 | Christiana Care Health Services Inc | Internal Medicine | 200 Hygeia Dr, Suite 2300, Newark, DE 19713-2049 | 2011-11-08 |
| 1982921888 | Lauren Blackwell | Internal Medicine | 150 Bergen St, Room I-248, Newark, NJ 07103-2496 | 2010-05-01 |
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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.