ENGLEWOOD DERMATOLOGY CENTER (NPI# 1588930663) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588930663 |
| Entity Type | Organization |
| Organization Name | ENGLEWOOD DERMATOLOGY CENTER |
| Practice Address |
300 Grand Ave Suite 201 Englewood NJ 07631-4398 |
| Practice Telephone | 2015695151 |
| Practice Fax Number | 2015699193 |
| Mailing Telephone | 2015695151 |
| Mailing Fax Number | 2015699193 |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2012-03-22 |
| Authorized Official Name | DR. LENIS GONZALEZ (M.D.) |
| Authorized Official Telephone | 2015695151 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305R00000X | Preferred Provider Organization | 207N00000X | NJ | Managed Care Organizations |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| INDIVIDUAL NPI | 1316145329 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811472111 | Englewood Dermatology Center | Dermatology | 300 Grand Ave Ste 201, Englewood, NJ 07631-6300 | 2018-10-02 |
| Street Address |
300 GRAND AVE SUITE 201 |
| City | ENGLEWOOD |
| State | NJ |
| Zip Code | 07631-4398 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114929635 | George Klafter | Urology | 300 Grand Ave, Suite 202, Englewood, NJ 07631-4398 | 2005-08-15 |
| 1376975649 | Mdstyle | Otolaryngology | 300 Grand Ave, Suite 104, Englewood, NJ 07631-4398 | 2013-08-08 |
| 1063858751 | Renal Center of Englewood, LLC | Clinic/Center | 300 Grand Ave, Ste 103, Englewood, NJ 07631-6300 | 2013-05-21 |
| 1326370172 | Chong Mu Lee | Acupuncturist | 300 Grand Ave, Suite 101, Englewood, NJ 07631-4398 | 2010-02-04 |
| 1346480738 | Rejuvenate Rehabilitation Center | Clinic/Center | 300 Grand Ave, Suite 101, Englewood, NJ 07631-4398 | 2009-02-25 |
| 1992901052 | Robert Bradley Simon | Urology | 300 Grand Ave, Suite 202, Englewood, NJ 07631-4398 | 2007-06-25 |
| 1518049832 | Gary D Wasserman | Urology | 300 Grand Ave, Suite 202, Englewood, NJ 07631-4398 | 2006-10-19 |
| 1144231515 | Monica Tadros | Specialist | 300 Grand Ave, Suite #104, Englewood, NJ 07631-4398 | 2006-08-11 |
| 1407846827 | Thomas Chun | Urology | 300 Grand Ave, Suite 202, Englewood, NJ 07631-4398 | 2005-10-26 |
| 1477555993 | Steven Katz | Urology | 300 Grand Ave, Suite 202, Englewood, NJ 07631-4398 | 2005-08-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447868922 | Sharmela Brijmohan | Student in an Organized Health Care Education/Training Program | 350 Engle Street Englewood Nj Department of Medicine, Englewood, NJ 07631 | 2020-07-21 |
| 1902422553 | Ross Tyrone Jensen Lavine | Student in an Organized Health Care Education/Training Program | 350 Engle Street, Department of Medicine, Englewood, NJ 07631 | 2020-06-19 |
| 1881235497 | Cbt and Psychodynamic Therapy Associates LLC | Social Worker | 245 Walnut Street, Englewood, NJ 07631 | 2019-10-04 |
| 1346895950 | Eb Care At Englewood, LLC | Assisted Living Facility | 412 South Van Brunt Street, Englewood, NJ 07631 | 2019-08-09 |
| 1730695727 | Maytal Elart | Spec/Tech, Cardiovascular | 151 E Palisades Ave, 16e, Englewood, NJ 07631 | 2017-12-28 |
| 1396259255 | Elizabeth Thottumalil Thomas | Counselor | 93 West Palisade Ave, Englewood, NJ 07631 | 2017-11-29 |
| 1992214381 | Englewood Orthopedics Group PC | Orthopaedic Surgery | 55 Smith St Unit 5653, Englewood, NJ 07631 | 2017-09-28 |
| 1639691579 | Jee Hoon Jang | Student in an Organized Health Care Education/Training Program | 350 Engle St., Englewood, NJ 07631 | 2017-07-12 |
| 1427570332 | Dan Ran Castillo | Student in an Organized Health Care Education/Training Program | 350 Engel Street, Engelwood, NJ 07631 | 2017-07-12 |
| 1275061392 | Thomas J Drexler | Counselor | 93 W. Palisades Ave, Englewood, NJ 07631 | 2017-06-02 |
| Find all providers in zip 07631 | ||||
| Taxonomy Code | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275881401 | Leslie Moldauer | Preferred Provider Organization | 10391 E Prentice Pl, Englewood, CO 80111-6245 | 2012-08-20 |
| 1316169741 | Aci Network | Preferred Provider Organization | 3575 S Sherman St Ste 3, Englewood, CO 80113-3798 | 2007-05-03 |
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| 1538617683 | Patricia Allocca | Preferred Provider Organization | 305 Atlantic Dr, Parsippany, NJ 07054-2441 | 2016-09-19 |
| 1750837803 | Jessica Plonchak | Preferred Provider Organization | 255 Sherman Ave, Teaneck, NJ 07666-3310 | 2016-08-29 |
| 1609227248 | Essex Pediatrics & Associates PC | Preferred Provider Organization | 654 Mount Prospect Ave, Newark, NJ 07104-3110 | 2016-06-24 |
| 1013372457 | Sewell Senior Citizen Center | Preferred Provider Organization | 475 Hurstville Cross Keys Rd, Suite A&b, Sewell, NJ 08080 | 2015-12-30 |
| 1487021309 | Bergen Smiles Dental Clinic, LLC | Preferred Provider Organization | 24 Godwin Ave Ste 102, Midland Park, NJ 07432-1962 | 2015-08-26 |
| 1972900777 | Advocacy Family Support Services. | Preferred Provider Organization | 41 La Gorce Blvd, Burlington, NJ 08016-2938 | 2014-11-24 |
| 1265852933 | Abt Counseling Pllc | Preferred Provider Organization | 1010 Haddonfield Berlin Rd Ste 300, Voorhees, NJ 08043-3514 | 2014-04-22 |
| 1811324650 | G L Payumo Md Pa | Preferred Provider Organization | 205 May St Ste 103, Edison, NJ 08837-3267 | 2013-10-10 |
| 1154753507 | United Anesthesia LLC | Preferred Provider Organization | 249 Bridge St Bldg G, Metuchen, NJ 08840-2294 | 2013-08-07 |
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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.