SUSAN TAMAGNI (NPI# 1992746242) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992746242 |
| Entity Type | Individual |
| Full Name | SUSAN TAMAGNI |
| Credential | PA-C |
| Practice Address |
159 S Broad St Woodbury NJ 08096-2410 |
| Mailing Address |
30 S Columbia St Woodbury NJ 08096-2103 |
| Practice Telephone | 8445422273 |
| Mailing Telephone | 8563847456 |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
MA-002428-L | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
25MP00032600 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | TPI MEDICAID GROUP | 100727800 | 01 |
| PA | TPI RAILROAD MEDICARE GROUP | CD4829 | 01 |
| PA | TPI MEDICARE GROUP | 597586 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 175 Madison Ave, Mount Holly, NJ 080602038 | 6092617046 | 6099146067 |
| Street Address |
159 S BROAD ST |
| City | WOODBURY |
| State | NJ |
| Zip Code | 08096-2410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942746367 | Kennedy Medical Group Practice P.C. | Family Medicine | 159 S Broad St, Woodbury, NJ 08096-2410 | 2017-01-09 |
| 1710390364 | Priya Shah | Internal Medicine | 159 S Broad St, Woodbury, NJ 08096-2410 | 2014-06-10 |
| 1376863530 | Ifeoma M Akumuo | Pharmacist | 159 S Broad St, Woodbury, NJ 08096-2410 | 2010-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780226043 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1460 Cooper Street, Deptford, NJ 08096 | 2019-10-08 |
| 1730652058 | Robert Crawford Counseling & Consultation, LLC | Counselor | Robert Crawford Counseling & Consultation, LLC, 44 Cooper Street, Suite 208, Woodbury, NJ 08096 | 2019-01-09 |
| 1902381171 | Services To Overcome Drug Abuse Among Teenagers, Inc. | Clinic/Center | 124 N Broad Street, Woodbury, NJ 08096 | 2018-10-03 |
| 1225518715 | Michael West | Pharmacist | 631 West Mantua Ave, Woodbury, NJ 08096 | 2018-08-15 |
| 1053807891 | Standing Ground Counseling, LLC | Clinic/Center | 44 Cooper Street, Suite 104, Woodbury, NJ 08096 | 2018-07-05 |
| 1376054536 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 40 Hessian Avenue, Woodbury, NJ 08096 | 2017-10-16 |
| 1881105021 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1154 Bennett Drive, Deptford, NJ 08096 | 2017-10-16 |
| 1215448469 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7 North Evergreen Avenue, Woodbury, NJ 08096 | 2017-10-16 |
| 1801307137 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6 North Drexel Street, Woodbury, NJ 08096 | 2017-10-13 |
| 1295253847 | Sara Alven | Social Worker | 1 Lupton Avenue, Woodbury, NJ 08096 | 2017-09-05 |
| Find all providers in zip 08096 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013496892 | Daniel Louis Fazzino | Physician Assistant | 76 Barnhill Rd, Woodbury, CT 06798-2219 | 2018-08-12 |
| 1871789123 | Alissa Paul | Physician Assistant | 449 Commerce Dr, Woodbury, MN 55125-4872 | 2007-09-20 |
| 1457460743 | Anthony F Orlando | Physician Assistant | 608 N Broad St, Suite 100, Woodbury, NJ 08096-1794 | 2006-08-30 |
| 1437523248 | Abigail House Tierney | Physician Assistant | 1875 Woodwinds Dr, Woodbury, MN 55125-2298 | 2015-11-17 |
| 1396149910 | Matthew Voit | Physician Assistant | 509 N Broad St, Woodbury, NJ 08096-1617 | 2014-10-09 |
| 1588086821 | Krystina Zeliff | Physician Assistant | 875 Mantua Pike, Woodbury, NJ 08096 | 2014-01-06 |
| 1326312430 | Brian W. Boockoff | Physician Assistant | 414 Tatum St, Woodbury, NJ 08096-3499 | 2012-03-07 |
| 1790068989 | Leslie Ann Davis | Physician Assistant | 45 Crossways Park Dr W, Woodbury, NY 11797-2037 | 2011-09-23 |
| 1467733816 | Andrea M Bolesta | Physician Assistant | 509 N Broad St, Woodbury, NJ 08096-1617 | 2011-08-30 |
| 1679897060 | Jacqueline Marjorie Lichtenstein | Physician Assistant | 45 Crossways Park Dr W, Woodbury, NY 11797-2037 | 2010-03-15 |
| Find all providers in WOODBURY | ||||
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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.