SUSAN L MAIOCCO


Address: 111 Central Ave, Saint Michael's Medical Center Primarycareclinic1st Fl., Newark, NJ 07102-1909
Phone: 9738775080

SUSAN L MAIOCCO (NPI# 1629028568) 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) 1629028568
Entity Type Individual
Full Name SUSAN L MAIOCCO
Credential APN
Practice Address 111 Central Ave
Saint Michael's Medical Center Primarycareclinic1st Fl.
Newark
NJ 07102-1909
Practice Telephone 9738775080
Practice Fax Number 9738772718
Mailing Telephone 9738775080
Mailing Fax Number 9738772718
Enumeration Date 2006-05-11
Last Update Date 2014-04-08
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163W00000X Registered Nurse 26NO05261700 NJ Nursing Service Providers
Y 363LA2200X Nurse Practitioner
Specialization: Adult Health
26NJ00070900 NJ Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 111 CENTRAL AVE
SAINT MICHAEL'S MEDICAL CENTER PRIMARYCARECLINIC1ST FL.
City NEWARK
State NJ
Zip Code 07102-1909

Providers in the same location

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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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
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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 Information

Taxonomy Code 363LA2200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Adult Health

Taxonomy Definition

Definition to come...

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1568029411 Ashley Nicole Warren Nurse Practitioner Newark Beth Israel Medical Center, 201 Lyons Ave, Newark, NJ 07112-1782 2019-05-28
1871077404 Aisha E Wagner Nurse Practitioner 1304 Driving Park Avenue, Newark, NY 14513 2018-09-19
1851884456 Dionne Hutson Hendy Nurse Practitioner 52-54 Richelieu Ter, Newark, NJ 07106-1648 2018-06-08
1922472620 Laura Kretz Mayover Nurse Practitioner 4755 Ogletown Stanton Rd Ste 1e50, Newark, DE 19718-2200 2015-11-18
1710312848 Saino Mathew Nurse Practitioner 418 N 13th St, Apt # 1, Newark, NJ 07107-1384 2013-09-09
1871886549 Debora Gildin Nurse Practitioner Continental Airline's Take-care Health Center, Newark International Airport Terminal C, Suite 136, Newark, NJ 07114 2011-05-27
1730486754 Patricia Marie Wolf Nurse Practitioner 1818 Preston Pl, Newark, OH 43055-9328 2011-02-28
1518192640 Michaelene M Baker Urban Nurse Practitioner Building B 86, Omega Drive, Newark, DE 19713-6004 2009-05-19
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Competitor

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City NEWARK
Zip Code 07102

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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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