MR. TIMOTHY GODFREY (NPI# 1689108987) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689108987 |
| Entity Type | Individual |
| Full Name | MR. TIMOTHY GODFREY |
| Credential | PA |
| Practice Address |
76 Willowbrook Blvd Wayne NJ 07470-7002 |
| Practice Telephone | 8622467938 |
| Mailing Telephone | 8622467938 |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2020-05-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
25MP00560000 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
76 WILLOWBROOK BLVD |
| City | WAYNE |
| State | NJ |
| Zip Code | 07470-7002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841714649 | City Medical of New Jersey, PC | Clinic/Center | 76 Willowbrook Blvd, Wayne, NJ 07470-7002 | 2017-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669073086 | Brightview Hamburg, LLC | Alzheimer Center (Dementia Center) | 1139 Hamburg Turnpike, Wayne, NJ 07470 | 2020-11-03 |
| 1912536301 | Stevenson Dominique | Physician Assistant | 1700 Nj-23 # 170, Wayne, NJ 07470 | 2020-04-07 |
| 1710524087 | Engel Burman At Wayne, LLC | Assisted Living Facility | 1440 Hamburg Turnpike, Wayne, NJ 07470 | 2019-12-05 |
| 1508412669 | Jessie Diana Dunitz | Technician | 66 Sandra Lane, Wayne, NJ 07470 | 2019-08-14 |
| 1447737234 | Meza Behavioral Health, Inc. | Psychologist | 40 Edgemont Crescent, Wayne, NJ 07470 | 2018-07-24 |
| 1881188076 | Christine Nolan | Occupational Therapist | 1 Pike Drive, Wayne, NJ 07470 | 2018-06-20 |
| 1033612403 | County of Passaic Department of Finance | Skilled Nursing Facility | 305 Oldham Road, Wayne, NJ 07470 | 2018-03-13 |
| 1144739590 | Broadway Respite and Home Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7 Allen Drive, Wayne, NJ 07470 | 2017-09-28 |
| 1679096697 | Wafaa Saad | Counselor | 1009 Valley Rd, Wayne, NJ 07470 | 2017-07-21 |
| 1659803138 | Allison Nicole Diangelo | Nurse Practitioner | 1578 Rte 23, Wayne, NJ 07470 | 2017-04-03 |
| Find all providers in zip 07470 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295780682 | Rosalie C Cuozzo | Physician Assistant | 145 Us Highway 46, Suite 304, Wayne, NJ 07470-6830 | 2006-05-23 |
| 1457829442 | Katelyn Haarer | Physician Assistant | 1055 Hamburg Tpke, Wayne, NJ 07470-3235 | 2018-11-07 |
| 1790928273 | Robert P Janusz | Physician Assistant | 145 Us Highway 46, Suite 304, Wayne, NJ 07470-6830 | 2009-04-13 |
| 1275723231 | Dana Gabrielle Garcia | Physician Assistant | 1777 Hamburg Tpke, Suite 305, Wayne, NJ 07470-5211 | 2007-07-26 |
| 1366658478 | Michele Lynne Lohman | Physician Assistant | 145 Us Highway 46, Suite 304, Wayne, NJ 07470-6830 | 2007-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062463 | Erica Josephine Lobuglio | Physician Assistant | 733 N Beers St Ste U3, Holmdel, NJ 07733-1513 | 2020-08-04 |
| 1407471493 | Angelice Grasso | Physician Assistant | 3 Holly Ln, Garfield, NJ 07026-3565 | 2020-06-15 |
| 1063036358 | Jaina Marie Lumkong | Physician Assistant | 905 Allwood Rd Ste 204, Clifton, NJ 07012-1946 | 2020-06-02 |
| 1740804384 | Allison Sy Tan | Physician Assistant | 10 Bahr Cir, Verona, NJ 07044-3200 | 2020-05-29 |
| 1114560851 | Brian Paul Leonhardt | Physician Assistant | 1113 Hospital Drive Professional Building East, Suite 100, Willingboro, NJ 08046 | 2019-10-25 |
| 1740830413 | Atara Hagler | Physician Assistant | 1500 Pleasant Valley Way Ste 101, West Orange, NJ 07052-2956 | 2019-09-16 |
| 1568943058 | Ekaterina M Rezvin | Physician Assistant | 80 Woodland Park Dr, Tenafly, NJ 07670-3028 | 2018-08-23 |
| 1225550353 | Kristen Cordiello | Physician Assistant | 1610 Route 88 Ste 203, Brick, NJ 08724-3018 | 2017-07-11 |
| 1710408232 | Angela Marie Freedman | Physician Assistant | 1 Riverview Plaza Multi Disciplinary Cancer Center, Red Bank, NJ 07701 | 2017-07-06 |
| 1063932259 | Matthew Gabriel | Physician Assistant | 25 Prospect Avernue, 2nd Floor, Hackensack, NJ 07601 | 2017-06-20 |
| 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.