CLINICAL PRACTICE PC


Address: 90 Bergen St, Newark, NJ 07103-2425
Phone: 9739725004

CLINICAL PRACTICE PC (NPI# 1568829448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1568829448
Entity Type Organization
Organization Name CLINICAL PRACTICE PC
Practice Address 90 Bergen St
Newark
NJ 07103-2425
Mailing Address 30 Bergen St
Rm 1205
Newark
NJ 07107-3000
Practice Telephone 9739725004
Enumeration Date 2016-01-22
Last Update Date 2016-01-22
Authorized Official Name MICHAEL J SAULICH (EXECUTIVE DIRECTOR & CEO)
Authorized Official Telephone 9739725004
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 90 BERGEN ST
City NEWARK
State NJ
Zip Code 07103-2425

Providers in the same location

NPI Name Taxonomy Address Enumeration
1285623074 Karen Virginia Valdez-gonzalez Genetic Counselor, MS 90 Bergen St, Doctors Office Center - Suite 5400, Newark, NJ 07103-2425 2005-10-14
1134758816 Elizabeth Elaine Ginalis Student in an Organized Health Care Education/Training Program 90 Bergen St, Newark, NJ 07103-2425 2020-04-05
1003462854 University Surgical Associates (om) Transplant Surgery 90 Bergen St, Newark, NJ 07103-2425 2019-08-16
1528614021 Special LLC Plastic Surgery 90 Bergen St, Newark, NJ 07103-2425 2019-08-12
1265993216 Sean Michael Munier Student in an Organized Health Care Education/Training Program 90 Bergen St, Newark, NJ 07103-2425 2019-03-30
1629539861 Ali Tayebi Meybodi Student in an Organized Health Care Education/Training Program 90 Bergen St, Newark, NJ 07103-2425 2019-03-29
1497214282 Brandon Khoa Nguyen Student in an Organized Health Care Education/Training Program 90 Bergen St, Newark, NJ 07103-2425 2019-03-19
1649776790 Purvee D Patel Student in an Organized Health Care Education/Training Program 90 Bergen St, Newark, NJ 07103-2425 2018-04-05
1740716703 Elena Solli Student in an Organized Health Care Education/Training Program 90 Bergen St, Doctor's Office Center, Neurological Surgery Dept., Newark, NJ 07103-2425 2017-05-11
1881120954 Ivo Bach Student in an Organized Health Care Education/Training Program 90 Bergen St, Suite 5200, Newark, NJ 07103-2425 2017-05-10
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1124657077 Yingna Liu Student in an Organized Health Care Education/Training Program Medical Science Building, 185 South Orange Avenue, Newark, NJ 07103 2020-04-03
1568029684 Martins Akhibi Nurse Practitioner 178 Newton Street, Newark, NJ 07103 2019-05-23
1972168482 Newark Renaissance House, Inc Rehabilitation, Substance Use Disorder Unit 50-56 Norfolk Street, Newark, NJ 07103 2019-05-09
1346709235 Ian Wang Yu Student in an Organized Health Care Education/Training Program 185 South Orange Ave., Medical Science Building, Room I-506, Newark, NJ 07103 2019-03-19
1437648417 Stephen Vanbeek Internal Medicine 185 S Orange Ave Rm 547, Newark, NJ 07103 2018-05-06
1073019444 Geoffrey Alexander Talis Student in an Organized Health Care Education/Training Program 183 S. Orange Avenue, Level E, Room 1452, Newark, NJ 07103 2018-04-03
1285139907 Thomas Georg Bachmann Student in an Organized Health Care Education/Training Program 185 South Orange Ave, Medical Science Building, G-538, Newark, NJ 07103 2018-03-26
1154825289 Shammi A Patel Student in an Organized Health Care Education/Training Program 185 S Orange Ave # Msbg594, Newark, NJ 07103 2018-03-22
1982122545 North Jersey Aids Alliance Clinic/Center 393 Central Avenue C/o Corey Destefano, Newark, NJ 07103 2017-09-05
1134655533 Yasmin N Abedin Student in an Organized Health Care Education/Training Program 185 South Orange Ave, Msb E-506, Rutgers, New Jersey Medical School, Newark, NJ 07103 2017-05-04
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Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1326647488 Julia Siyao Yu Physician Assistant 541 Oakdale Rd Apt D, Newark, DE 19713-2928 2020-10-20
1376001990 Kiley Dale Titus Physician Assistant 165 E Union St, Newark, NY 14513-1559 2019-03-04
1528559457 Sarah Mun Physician Assistant 4755 Ogletown Stanton Rd, Newark, DE 19713 2018-05-26
1750833646 Rosalyn Hightower Physician Assistant 1213 Churchmans Rd, Newark, DE 19713-2149 2016-10-26
1013342757 Leia Lavoie Collins Physician Assistant 4735 Ogletown- Stanton Rd Map 2 Suite 1208, Newark, DE 19713-2072 2013-09-12
1447509179 Chloe E Dickinson Physician Assistant 550 S College Ave Ste 115, Newark, DE 19706-1308 2012-09-10
1447509591 Drew Pento Physician Assistant 4051 Ogletown Stanton Rd, Newark, DE 19718-0001 2012-09-05
1568711034 Jacqueline Pellenbarg Physician Assistant 4701 Ogletown Stanton Rd Ste 2100, Newark, DE 19713-7000 2012-08-30
1912284530 Ian A Blizzard Physician Assistant 2600 Glasgow Ave Ste 124, Newark, DE 19702-4777 2011-11-10
1043596133 Victoria Leicht Physician Assistant 537 Stanton Christiana Rd Ste 209, Newark, DE 19713-2148 2011-11-02
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Competitor

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City NEWARK
Zip Code 07103

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Dataset Information

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.

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