DR. PUDCHONG S SRISETHNIL (NPI# 1770690315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770690315 |
| Entity Type | Individual |
| Full Name | DR. PUDCHONG S SRISETHNIL |
| Credential | M.D., F.A.C.E. |
| Practice Address |
561 E 28th St Paterson NJ 07504-1825 |
| Practice Telephone | 9732784673 |
| Practice Fax Number | 9732780450 |
| Mailing Telephone | 9732784673 |
| Mailing Fax Number | 9732780450 |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
MA30779 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | TAX ID | 222385269 | 01 |
| NJ | DEA # | AS6993845 | 01 |
| NJ | LICENSE # | MA30779 | 01 |
| Street Address |
561 E 28TH ST |
| City | PATERSON |
| State | NJ |
| Zip Code | 07504-1825 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497206528 | Awilda Vasquez Yambo | Massage Therapist | 561 E 28th St, Paterson, NJ 07504-1862 | 2016-10-24 |
| 1952744872 | Pudchong Srisethnil, Md, Pa | Internal Medicine | 561 E 28th St, Paterson, NJ 07504-1862 | 2013-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881051696 | Jacqueline Yvonne Ghee | Social Worker | 612 14th Ave., Clifton, NJ 07504 | 2016-01-25 |
| 1962723429 | Karen L Douglas | Counselor | 253 18th Avenue, Paterson, NJ 07504 | 2010-06-18 |
| 1235303934 | Cherryl Lewis-berry | Licensed Practical Nurse | 284 Wall Ave, Patterson, NY 07504 | 2008-04-15 |
| 1760672380 | Jonathan Bruce Spages | Chiropractor | 234 Mclean Blvd, Paterson, NJ 07504 | 2007-07-30 |
| 1417147257 | David Neal Rendelstein | Chiropractor | 234 Mclean Blvd, Paterson, NJ 07504 | 2007-07-27 |
| 1346309754 | Nart Tsay | Chiropractor | 567 Park Ave, Paterson, NJ 07504 | 2006-12-08 |
| 1154566198 | Rehan Hassanin Seyam | Counselor | 152 Derrom Ave, Paterson, NJ 07504-1003 | 2008-12-04 |
| 1780134783 | Bryant Flores | Chiropractor | 567 Park Ave, Paterson, NJ 07504-1006 | 2016-10-13 |
| 1508928748 | Kamel Kazan | Chiropractor | 567 Park Ave, Paterson, NJ 07504-1006 | 2006-12-14 |
| 1174021596 | Echo Care LLC | Home Health | 244 Wall Ave, Paterson, NJ 07504-1016 | 2018-01-31 |
| Find all providers in zip 07504 | ||||
| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952744872 | Pudchong Srisethnil, Md, Pa | Internal Medicine | 561 E 28th St, Paterson, NJ 07504-1862 | 2013-04-10 |
| 1255651873 | Sandra Gibiezaite | Internal Medicine | 703 Main St, St Joseph Regional Hospital Center, Dept of Medicine, Paterson, NJ 07503-2621 | 2010-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295373645 | Freehold Rheumatology and Endocrinology LLC | Internal Medicine | 535 Iron Bridge Rd Ste 11, Freehold, NJ 07728-5301 | 2019-12-17 |
| 1396302014 | Advocare, LLC | Internal Medicine | 256 Bunn Dr Ste D, Princeton, NJ 08540-2859 | 2019-05-29 |
| 1952871667 | Garger Center for Endocrinology PC | Internal Medicine | 10 Sycamore Ave Ste 1, Ho Ho Kus, NJ 07423-1588 | 2018-11-26 |
| 1962902189 | Mercer Endocrine Care LLC | Internal Medicine | 2139 Route 33 Ste A, Hamilton, NJ 08690-1751 | 2018-02-14 |
| 1144740739 | Clarion Technology LLC | Internal Medicine | 5000 Atrium Way Ste 3, Mount Laurel, NJ 08054-3915 | 2017-06-23 |
| 1295115277 | Mabel Mayorga | Internal Medicine | 401 Haddon Ave Fl 2, Camden, NJ 08103 | 2015-06-04 |
| 1265832463 | Elkin A Nunez Md, LLC | Internal Medicine | 213 Winding Hill Dr, Hackettstown, NJ 07840-5665 | 2014-08-26 |
| 1962812040 | Reem Taha | Internal Medicine | 2 Lincoln Hwy Ste 502, Edison, NJ 08820-3961 | 2014-04-29 |
| 1043637192 | Fadwa Sumrein | Internal Medicine | 2 Brighton Rd Ste 400, Clifton, NJ 07012 | 2014-03-26 |
| 1811335433 | Taher Modarressi | Internal Medicine | 9100 Wescott Dr Ste 101, Flemington, NJ 08822 | 2013-06-05 |
| 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.