CATHEDRAL PHYSICIAN GROUP, PC (NPI# 1780884031) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1780884031 |
Entity Type | Organization |
Organization Name | CATHEDRAL PHYSICIAN GROUP, PC |
Practice Address |
1160 Raymond Blvd 8th Floor - Physician Services Newark NJ 07102-4168 |
Mailing Address |
111 Central Ave 1st Floor Newark NJ 07102-1909 |
Practice Telephone | 9734912958 |
Mailing Telephone | 9738775000 |
Enumeration Date | 2007-07-24 |
Last Update Date | 2007-07-24 |
Authorized Official Name | LUIS BENDEZU (PHYSICIAN) |
Authorized Official Telephone | 9738775188 |
Authorized Official Credential | MD |
Is Organization Subpart | Y |
Parent Organization Name | SAINT MICHAELS MEDICAL CENTER |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NJ | PENDING | 05 |
Street Address |
1160 RAYMOND BLVD 8TH FLOOR - PHYSICIAN SERVICES |
City | NEWARK |
State | NJ |
Zip Code | 07102-4168 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447244967 | Angel A Hernandez | Psychiatry & Neurology | 1160 Raymond Blvd, Newark, NJ 07102-4199 | 2005-09-12 |
1669597837 | James Francis Tortora | Psychologist | 1160 Raymond Blvd, Newark, NJ 07102 | 2007-03-20 |
1538283346 | Sheila Crowe | Nutritionist | 1160 Raymond Blvd, 4th Floor, Newark, NJ 07102-4168 | 2007-03-19 |
1972635712 | Marise Carraha | Registered Nurse | 1160 Raymond Blvd, 2nd Floor, Newark, NJ 07102 | 2007-03-09 |
1104957968 | Renee Cheryl Williams | Registered Nurse | 1160 Raymond Blvd, Newark, NJ 07102-4168 | 2007-03-07 |
1013059575 | Vody Elaine Vincent | Registered Nurse | 1160 Raymond Blvd, 5th Floor, Newark, NJ 07102-4168 | 2007-02-13 |
1457491250 | Garnnette D Ali | Registered Nurse | 1160 Raymond Blvd, 5th Floor, Newark, NJ 07102-4168 | 2007-02-08 |
1689712895 | Marcelo Velazquez | Counselor | 1160 Raymond Blvd, Newark, NJ 07102-4168 | 2007-02-01 |
1477607851 | Rafael M Tortosa-nacher | Psychiatry & Neurology | 1160 Raymond Blvd, Newark, NJ 07102-4168 | 2007-01-22 |
1740344076 | Ccs - Partenership for Children | Community/Behavioral Health | 1160 Raymond Blvd, Newark, NJ 07102-4168 | 2006-12-21 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487253779 | Integrity, Inc | Clinic/Center | 1091-1093 Broad Street, Newark, NJ 07102 | 2020-10-19 |
1881292720 | Oluwaseun Ademulegun | Pharmacist | 1084 Broad Street, Newark, Newark, NJ 07102 | 2020-10-13 |
1679042295 | Henry Paul Grayner | Specialist/Technologist | 100 Lock St, Newark, NJ 07102 | 2018-11-14 |
1548736838 | Integrity, Inc | Substance Abuse Rehabilitation Facility | 101 Lincoln Park, 2nd Floor, Newark, NJ 07102 | 2018-10-15 |
1962981407 | Crystal Kay-baune Mccown | Social Worker | 130 Orange St, Newark, NJ 07102 | 2018-08-07 |
1053808865 | Nubi Consultants Corp. Dba Aplus Home Care | Physical Therapist | 11 Franklin Street, 11 Franklin Street, Newark, NJ 07102 | 2018-04-17 |
1396249264 | Integrity, Inc | Substance Abuse Rehabilitation Facility | 49 Lincoln Park, Newark, NJ 07102 | 2018-03-23 |
1568960896 | Saint James Health Inc | Clinic/Center | 36 Halsey Street, Newark, NJ 07102 | 2018-02-01 |
1992216527 | Metropolitan Center for Human Services | Psychologist | 520 Dr. Martin Luther King, Jr. Boulevard, Newark, NJ 07102 | 2017-10-23 |
1467974949 | Ahmad Mohammad Tawfiq Damati | Student in an Organized Health Care Education/Training Program | 123 University Ave, Newark, Nj 07102, Newark, NJ 07102 | 2017-07-17 |
Find all providers in zip 07102 |
Taxonomy Code | 207R00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
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. |
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1114554532 | Rwjbh Associates 2, LLC | Internal Medicine | 155 Jefferson St # Ll, Newark, NJ 07105-6906 | 2020-03-25 |
1538790563 | North Ward Medical Arts LLC | Internal Medicine | 485-491 Mt Prospect Ave, Newark, NJ 07104 | 2020-01-29 |
1538709837 | Saloojas Inc. | Internal Medicine | 5763 Stevenson Blvd Ste A, Newark, CA 94560-5301 | 2020-01-14 |
1528600715 | Roseville Health Center Inc. | Internal Medicine | 500 Orange St Fl 2, Newark, NJ 07107-2944 | 2019-10-09 |
1457912388 | Vanessa Browne | Internal Medicine | 185 S Orange Ave Rm I-506, Newark, NJ 07103-2757 | 2019-06-21 |
1477024867 | Hazera Khatun | Internal Medicine | 111 Central Ave Dept Of, Newark, NJ 07102-1909 | 2018-12-10 |
1437648417 | Stephen Vanbeek | Internal Medicine | 185 S Orange Ave Rm 547, Newark, NJ 07103 | 2018-05-06 |
1720504905 | Tri-state Physicians Inc | Internal Medicine | 266 South College Ave, Newark, DE 19711 | 2017-08-18 |
1649700253 | Cheryl Emilia Monteiro | Internal Medicine | 183 S Orange Ave # F1416, Newark, NJ 07103-2757 | 2017-06-15 |
1871029199 | Saira Zafar | Internal Medicine | 90 Bergen St # 4700, Newark, NJ 07103-2425 | 2017-05-05 |
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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.