DEANE A PENN (NPI# 1669445557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669445557 |
| Entity Type | Individual |
| Full Name | DEANE A PENN |
| Credential | M.D. |
| Practice Address |
1600 Parker Ave Fort Lee NJ 07024-7050 |
| Practice Telephone | 2014612507 |
| Practice Fax Number | 2014614146 |
| Mailing Telephone | 2014612507 |
| Mailing Fax Number | 2014614146 |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 25MA02573000 | NJ | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 0691704 | 05 | |
| NJ | OXFORD | BS469 | 01 |
| Street Address |
1600 PARKER AVE |
| City | FORT LEE |
| State | NJ |
| Zip Code | 07024-7050 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710962949 | Mika Ishitani | Chiropractor | 1600 Parker Ave, Ste #1, Fort Lee, NJ 07024-7050 | 2005-12-09 |
| 1386280519 | Humaira Quraishi | Nutritionist | 1600 Parker Ave, Fort Lee, NJ 07024-7050 | 2019-11-22 |
| 1144543661 | Theodore George Prince | Pharmacist | 1600 Parker Ave, 9b, Fort Lee, NJ 07024-7050 | 2010-03-11 |
| 1104067875 | Shana Lazar | Speech-Language Pathologist | 1600 Parker Ave, 11a, Fort Lee, NJ 07024-7050 | 2009-03-10 |
| 1669525531 | Spini Sol Levante PC | Clinic/Center | 1600 Parker Ave, Ste #1, Fort Lee, NJ 07024-7050 | 2007-01-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043828726 | You S Jung | Pharmacist | 1275 15th Street Apt 2e, Fort Lee, NJ 07024 | 2020-07-17 |
| 1205316528 | Professional Orthopedic and Sports Therapy of Nj, LLC | Physical Therapist | 2200 Fletcher Ave Ste 505, Fort Lee, NJ 07024 | 2018-08-16 |
| 1194210138 | Hyunjoo Lee | Pharmacy | 168 Fletcher Ave, Fort Lee, NJ 07024 | 2018-06-22 |
| 1912423724 | Fort Lee Health Supplies | Durable Medical Equipment & Medical Supplies | 96 Linwood Plaza Rte 9 W, Fort Lee, NJ 07024 | 2017-08-15 |
| 1669997482 | Jinseok Woo | Acupuncturist | 6 Horizon Rd., Apt 2504, Fort Lee, NJ 07024 | 2017-08-14 |
| 1578083705 | Sheran Rey | Licensed Vocational Nurse | 6308 Hilltop Ct, Fort Lee, NJ 07024 | 2017-06-20 |
| 1558812909 | Jian Cui | Acupuncturist | 500 Linwood Drive Apt3c, Fort Lee, NJ 07024 | 2016-10-20 |
| 1013392919 | Yulong Yang | Internal Medicine | 2083 Center Ave Ste 2a, Fort Lee, NJ 07024 | 2015-07-22 |
| 1235561796 | Anthony Lucev | Student in an Organized Health Care Education/Training Program | 233 Harmon Ave, Fort Lee, NJ 07024 | 2013-08-06 |
| 1811331598 | Bridgeview Rehabilitation and Medical Arts Center | Physical Medicine & Rehabilitation | 454 Main Street 3rd Floor, Fort Lee, NJ 07024 | 2013-04-24 |
| Find all providers in zip 07024 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063966380 | Katiuska Pena | Specialist | 1640 Federspiel St, Fort Lee, NJ 07024-6906 | 2016-08-04 |
| 1952768061 | Myong Yi | Specialist | 1475 Bergen Blvd Ste 5, Fort Lee, NJ 07024-2164 | 2016-01-20 |
| 1013372226 | Melissa Monteiro | Specialist | 2160 Center Ave Apt 5l, Fort Lee, NJ 07024-5829 | 2015-12-15 |
| 1326417163 | Sonia Blanco Florentino | Specialist | 1 Casper Ln, Fort Lee, NJ 07024-2901 | 2015-09-23 |
| 1326382565 | Jurga Ciutaite | Specialist | 247 Bellemeade Ave, Fort Lee, NJ 07024-4348 | 2012-11-10 |
| 1841427499 | Boris Mordkovich Md Plastic Surgery, PC | Specialist | 96 Linwood Plz # 307, Fort Lee, NJ 07024-3701 | 2009-06-22 |
| 1205982949 | Tatiana Krasikov | Specialist | 2200 Fletcher Avenue, Fort Lee, NJ 07024 | 2007-01-26 |
| 1669439543 | Yoon Hee Choi | Specialist | 1355 15th St. Suite 190, Fort Lee, NJ 07024-1697 | 2006-04-26 |
| 1659334498 | Mira Shin | Specialist | 2050 Center Ave, Ste 425, Fort Lee, NJ 07024-4911 | 2006-04-11 |
| 1831152867 | John S Kim | Specialist | 2500 Lemoine Ave, Fort Lee, NJ 07024-6232 | 2006-04-10 |
| Find all providers in FORT LEE | ||||
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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.