SILVER LAKE MEDICAL PC (NPI# 1538366679) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538366679 |
| Entity Type | Organization |
| Organization Name | SILVER LAKE MEDICAL PC |
| Practice Address |
36 Newark Avenue Suite 324 Belleville NJ 07109 |
| Practice Telephone | 9737512060 |
| Practice Fax Number | 9737513334 |
| Mailing Telephone | 9737512060 |
| Mailing Fax Number | 9737513334 |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2008-06-16 |
| Authorized Official Name | DR. ANTONIO CICCONE (PRESIDENT) |
| Authorized Official Telephone | 9737512060 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MB57523 | NJ | Allopathic & Osteopathic Physicians |
| Street Address |
36 NEWARK AVENUE SUITE 324 |
| City | BELLEVILLE |
| State | NJ |
| Zip Code | 07109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083633283 | Erol Ulker | Urology | 36 Newark Avenue, Suite 200 Urology Consultants Pa, Belleville, NJ 07109-4121 | 2006-07-19 |
| 1376108712 | Ocean Audiology Inc | Audiologist | 36 Newark Avenue, Suite 130, Belleville, NJ 07109 | 2019-05-01 |
| 1710031919 | Ligresti Dermatology Associates Pa | Dermatology | 36 Newark Avenue, Suite 120, Belleville, NJ 07109-4120 | 2007-01-23 |
| 1609982099 | Urology Consultants Pa | Urology | 36 Newark Avenue, Suite 200, Belleville, NJ 07109-4121 | 2006-08-21 |
| 1639192800 | Anthony Delgaizo | Urology | 36 Newark Avenue, Suite 200 Urology Consultants Pa, Belleville, NJ 07109-4121 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851871370 | Mario Jr Millan | Clinic/Center | 114 Washington Avenue, Belleville, NJ 07109 | 2018-08-14 |
| 1881186641 | Wayne J Caputo Dpm | Podiatrist | 5 S Franklin Avenue, Belleville, NJ 07109 | 2018-06-06 |
| 1457842429 | Gout Institute of America | Anesthesiology | 727 Joralemon St., Belleville, NJ 07109 | 2018-05-24 |
| 1477078632 | Keith Pishna | Social Worker | 224 Washington Avenue, Belleville, NJ 07109 | 2017-08-09 |
| 1669915906 | Priyankaben Gajjar | Nurse Practitioner | 668 Mill St, Apt A5, Belleville, NJ 07109 | 2016-11-18 |
| 1861878829 | 1st Cerebral Palsy of New Jersey | Contractor | 31 Cuozzo Street, Belleville, NJ 07109 | 2015-07-31 |
| 1730562323 | 1st Cerebral Palsy of New Jersey | Contractor | 20-28 Rocco Street, Apartment 20, Belleville, NJ 07109 | 2015-07-01 |
| 1407241441 | Janet Labadie | Nurse Practitioner | 140 Belmont Avenue, Bellevile, NJ 07109 | 2015-04-06 |
| 1790180537 | Eshwary Yerramsetty | Pharmacist | 345 S Franklin Ave, Walgreens Pharmacy, Belleville, NJ 07109 | 2014-10-22 |
| 1477971794 | Molly Marie Murray | Physician Assistant | 1 Clara Maass Dr., Belleville, NJ 07109 | 2014-04-03 |
| Find all providers in zip 07109 | ||||
| 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 |
|---|---|---|---|---|
| 1417591173 | Dimi Dawn Resch | Family Medicine | 373 Roanoke Dr, Belleville, IL 62221-5723 | 2019-11-05 |
| 1013559749 | Christine Evansco | Family Medicine | 105 S 35th St, Belleville, IL 62226-6314 | 2019-10-15 |
| 1851800288 | Republic County Family Clinic, P.a. | Family Medicine | 2337 G St Ste 2, Belleville, KS 66935-2462 | 2017-09-28 |
| 1154854008 | Kurtis William Klecan | Family Medicine | 2337 G St Ste 100, Belleville, KS 66935-2462 | 2017-04-07 |
| 1144753096 | Ace Medical Services LLC | Family Medicine | 929 Ridgecrest Dr, Belleville, IL 62220-3163 | 2017-04-07 |
| 1558743138 | Patrick Nakashima-moran | Family Medicine | 2900 Frank Scott Pkwy W Ste 904, Belleville, IL 62223 | 2015-06-19 |
| 1871993139 | Wayne Bresee Cox II | Family Medicine | 10 Celeste Ct, Belleville, IL 62223-1907 | 2014-08-23 |
| 1811252547 | Jianming Alexander Lau | Family Medicine | 201 3rd St 200, Belleville, MI 48111-2605 | 2012-07-09 |
| 1548531320 | Donald H Buser | Family Medicine | 116 S Fairway Dr, Belleville, IL 62223-2228 | 2012-01-25 |
| 1275824096 | Pc Associates LLC | Family Medicine | 2129 W. Main St., Belleville, IL 62223 | 2011-04-27 |
| Find all providers in BELLEVILLE | ||||
| City | BELLEVILLE |
| Zip Code | 07109 |
Please comment or provide details below to improve the information on SILVER LAKE MEDICAL PC.
| 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.