DEAN PETER LICOPANTIS (NPI# 1760478010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760478010 |
| Entity Type | Individual |
| Full Name | DEAN PETER LICOPANTIS |
| Credential | DPM |
| Practice Address |
16 Pocono Rd #209 Denville NJ 07834-2901 |
| Practice Telephone | 9733317900 |
| Practice Fax Number | 9733317999 |
| Mailing Telephone | 9733317900 |
| Mailing Fax Number | 9733317999 |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2014-01-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 25MD001877 | NJ | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | BLUE CROSS | 24223299834 | 01 |
| NJ | 0943908 | 05 |
| Street Address |
16 POCONO RD #209 |
| City | DENVILLE |
| State | NJ |
| Zip Code | 07834-2901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629072046 | Yihong H. Cheng | Internal Medicine | 16 Pocono Rd, Suite 317, Denville, NJ 07834-2901 | 2005-06-13 |
| 1255883716 | Gady Berkovich | Nurse Practitioner | 16 Pocono Rd, Suit 208, Denville, NJ 07834-2901 | 2016-11-01 |
| 1457734311 | Advocare, LLC | Obstetrics & Gynecology | 16 Pocono Rd, Suite 105, Denville, NJ 07834-2901 | 2015-07-09 |
| 1639551518 | Dawn Rivera | Social Worker | 16 Pocono Rd, Suite 112, Denville, NJ 07834-2901 | 2015-06-26 |
| 1508245085 | Primary Care Partners, LLC | Pediatrics | 16 Pocono Rd, Suite 214, Denville, NJ 07834-2901 | 2015-05-29 |
| 1700279221 | Brian Shrager Md LLC | Surgery | 16 Pocono Rd, Suite 208, Denville, NJ 07834-2901 | 2015-03-09 |
| 1326445834 | Caitlin A Smith | Nurse Practitioner | 16 Pocono Rd, Denville, NJ 07834-2901 | 2014-11-26 |
| 1871997478 | Sandra L Wright | Nurse Practitioner | 16 Pocono Rd, Suite 110, Denville, NJ 07834-2901 | 2014-10-10 |
| 1295141547 | Primary Care Partners LLC | Family Medicine | 16 Pocono Rd, Suite 110, Denville, NJ 07834-2901 | 2014-07-08 |
| 1154753051 | Kristofer K Steingall | Physician Assistant | 16 Pocono Rd, Suite 100, Denville, NJ 07834-2901 | 2013-08-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891304622 | Rosemarie Proven-fahy | Social Worker | 3175 Rt. 10 Building C, Suite 700, Denville, NJ 07834 | 2020-07-28 |
| 1568083327 | Anand Jetti | Student in an Organized Health Care Education/Training Program | Prime Healthcare Consortium At St. Mary's General Hospi, 25 Pocono Road, Denville, NJ 07834 | 2020-05-04 |
| 1265088892 | Absolute Awakenings Treatment Center LLC | Clinic/Center | 3000 Route 10 West, Denville, NJ 07834 | 2019-08-09 |
| 1326607243 | Recovery Zone Solutions, LLC | Clinic/Center | 124 East Main Street, Ste#109, Denville, NJ 07834 | 2019-06-13 |
| 1477022770 | Green Leaf Dentistry, LLC | Dentist | 3155 Route 10, Suite 201, Denville, NJ 07834 | 2018-11-15 |
| 1366955528 | Megan D Lukany | Social Worker | 4 2nd Ave Ste 208-b, Denville, NJ 07834 | 2017-11-09 |
| 1235680430 | Jennifer Jeanty | Nurse Practitioner | 280 W Main St Fl 2, Denville, NJ 07834 | 2016-10-22 |
| 1689129942 | Alejandro Castano | Dentist | 16 Pocono Rd Ste 213, Denville, NJ 07834 | 2016-08-16 |
| 1265830830 | Denville Physical Therapy, LLC | Physical Therapist | 3155 Rte 10 E, Suite 112, Denville, NJ 07834 | 2014-12-15 |
| 1538565577 | Michael T. Cocuzza | Counselor | 76 Broadway Ste 200h, Denville, NJ 07834 | 2014-11-18 |
| Find all providers in zip 07834 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225315716 | Nirav R Shah | Podiatrist | 58 Nicole Dr, Denville, NJ 07834-9531 | 2011-11-10 |
| 1053486100 | Ronald Marc Sidorsky | Podiatrist | 3155 Route 10 East, Suite 215, Denville, NJ 07834 | 2006-11-22 |
| 1972761435 | Ankle & Foot Surgery, Pa | Podiatrist | 16 Pocono Rd, Suite 209, Denville, NJ 07834-2901 | 2008-05-30 |
| 1063432193 | Gerald I Bresner | Podiatrist | 75 Bloomfield Ave, Suite 106, Denville, NJ 07834-2735 | 2006-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720689102 | Foot and Soul | Podiatrist | 1 W State St, Trenton, NJ 08608-1205 | 2020-11-03 |
| 1407461387 | Quality Foot and Ankle Center | Podiatrist | 87 Bruswick Wood Dr, East Brunswick, NJ 08816-5601 | 2020-09-09 |
| 1992323844 | Ventnor Wellness | Podiatrist | 6601 Ventnor Ave # Troy12, Ventnor City, NJ 08406-2167 | 2020-07-08 |
| 1891310967 | Kathryn Stoedter Dpm LLC | Podiatrist | 69 Haddonfield Berlin Rd, Cherry Hill, NJ 08034-3572 | 2020-06-14 |
| 1316560576 | Quality Foot Care Center LLC | Podiatrist | 25 Clyde Rd Ste 101, Somerset, NJ 08873-5038 | 2020-05-22 |
| 1942834973 | Foot & Ankle Center of Sj | Podiatrist | 408 Chris Gaupp Dr Ste 300, Galloway, NJ 08205 | 2020-02-28 |
| 1902437643 | Harsh Patel Dpm Pa | Podiatrist | 4991 Route 42 Ste 8a, Turnersville, NJ 08012-1750 | 2020-01-31 |
| 1619508355 | Harsh Patel Dpm Pa | Podiatrist | 1529 Route 206 Ste L-1, Tabernacle, NJ 08088-8801 | 2020-01-31 |
| 1154980944 | New Jersey Podiatric Physicians & Surgeons Group LLC | Podiatrist | 2477 Hwy 516 Ste 101, Old Bridge, NJ 08857-4603 | 2019-06-06 |
| 1972068575 | Kathryn Stoedter, Dpm, LLC | Podiatrist | 2301 E Evesham Rd Ste 508, Voorhees, NJ 08043-4506 | 2019-02-07 |
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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.