MR. ADAM AVITABILE (NPI# 1649426479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649426479 |
| Entity Type | Individual |
| Full Name | MR. ADAM AVITABILE |
| Credential | PA-C |
| Practice Address |
208 Harristown Rd # Ll-2 Glen Rock NJ 07452 |
| Mailing Address |
208 Harristown Rd Ste Ll-2 Glen Rock NJ 07452-3308 |
| Practice Telephone | 2018821050 |
| Practice Fax Number | 2018821040 |
| Mailing Telephone | 2018821050 |
| Mailing Fax Number | 2018821040 |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2019-01-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
25MP00203500 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 300 Central Ave, East Orange, NJ 07018 | 9736728400 |
| Street Address |
208 HARRISTOWN RD # LL-2 |
| City | GLEN ROCK |
| State | NJ |
| Zip Code | 07452 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326566134 | Silverio Joseph Bumanlag | Physical Therapist | 251 Rock Road, Suite 2c, Glen Rock, NJ 07452 | 2017-08-31 |
| 1073030953 | Erin Leigh Leonard | Pediatrics | 37 Emerson Road, Glen Rock, NJ 07452 | 2017-08-23 |
| 1306389457 | Rock Physical Therapy & Sports Rehabilitation Inc | Clinic/Center | 251 Rock Rd Ste 2e, Glen Rock, NJ 07452 | 2016-11-22 |
| 1003215336 | Amanda Rose Peraino | Specialist | 17 Stonefield Road, Glen Rock, NJ 07452 | 2014-08-22 |
| 1083030225 | Kristopher D Paik | Dentist | Ridgewood Oral Surgery & Implant Center, 385 S. Maple Ave Ste 207, Glen Rock, NJ 07452 | 2014-03-12 |
| 1497016158 | Patricia A. Woods | Counselor | 849 Lincoln Avenue, Glen Rock, NJ 07452 | 2012-05-30 |
| 1114284239 | Eileen Kringle Mc Auley | Physical Therapist | 522 Broad Street, Glen Rock, NJ 07452 | 2012-04-13 |
| 1467748301 | Sujal P Patel | Orthopaedic Surgery | 85 Harristown Rd Ste 103, Glen Rock, NJ 07452 | 2011-06-20 |
| 1427219914 | John Koerner | Orthopaedic Surgery | 266 Harristown Road, Suite 100, Glen Rock, NJ 07452 | 2008-06-18 |
| 1114059920 | John Mena Hiras | Chiropractor | 466 South Maple Ave, Glen Rock, NJ 07452 | 2007-03-09 |
| Find all providers in zip 07452 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891300612 | Heather C. Williamson | Physician Assistant | 57 Willis Dr, West Trenton, NJ 08628 | 2020-09-09 |
| 1427660810 | Lauren Colacicco | Physician Assistant | 406 Nj-23 North, Franklin, NJ 07416 | 2020-08-18 |
| 1912525353 | Thy T Pham | Physician Assistant | 2 Capital Way Ste 407, Pennington, NJ 08534-2521 | 2020-07-13 |
| 1982226270 | Alexandra Bellisario | Physician Assistant | 7 Normandy Pl, Colts Neck, NJ 07722-1174 | 2020-05-11 |
| 1497394266 | Trevor Paul | Physician Assistant | 167 Us Highway 9 Ste 5, Englishtown, NJ 07726-9215 | 2019-12-27 |
| 1295371003 | Sujin Kim | Physician Assistant | 500 Grand Ave Ste 201, Englewood, NJ 07631-4968 | 2019-11-27 |
| 1811531767 | Kaceyanne Lynn Cerankowski | Physician Assistant | 3131 Princeton Pike Bldg 4a, Lawrenceville, NJ 08648-2201 | 2019-11-04 |
| 1760024665 | Paula Kolodynski | Physician Assistant | 355 Us Route 22, Springfield Township, NJ 07081 | 2019-10-11 |
| 1245871334 | Terrell Amanda Collins | Physician Assistant | 76 W Jimmie Leeds Rd Ste 201, Galloway, NJ 08205-9417 | 2019-10-01 |
| 1013561422 | Adrienne Lauren Rinaldi | Physician Assistant | 1400 State Highway 70, Relievus, Cherry Hill, NJ 08034-0000 | 2019-07-25 |
| Find all providers with the same taxonomy | ||||
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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.