Daniel J Waltuch (NPI# 1386059558, PAC ID# 0941579759) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PODIATRY.
| Nation Provider ID (NPI) | 1386059558 |
| PAC ID by PECOS | 0941579759 |
| Professional Enrollment ID | I20170711002369 |
| Full Name | Daniel J Waltuch |
| Organization Legal Name | SOVEREIGN MEDICAL GROUP LLC |
| Address |
265 E 33rd St Paterson NJ 07504-1668 |
| Phone Number | 9736841011 |
| Gender | M |
| Medical School | NEW YORK COLLEGE OF PODIATRIC MEDICINE |
| Graduation Year | 2014 |
| Primary Specialty | PODIATRY |
| Group Practice PAC ID | 1456535392 |
| Number of Group Practice Members | 38 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 310019 | ST JOSEPH'S HOSPITAL AND MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 299 Forest Ave, Paramus, NJ 07652-5424 | 2015999255 | SOVEREIGN MEDICAL GROUP LLC |
| 265 E 33rd St, Paterson, NJ 07504-1668 | 9736841011 | SOVEREIGN MEDICAL GROUP LLC |
| Organization Legal Name | SOVEREIGN MEDICAL GROUP LLC |
| Physicians | 41 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Karen M Bellapianta | Otolaryngology | Sovereign Medical Group LLC | 85 Harristown, Suite 105, Glen Rock, NJ 07452-3307 |
| Raffaella L Kalishman | Internal Medicine | Sovereign Medical Group LLC | 85 Harristown Rd, Suite 104, Glen Rock, NJ 07452-3323 |
| Elliot L Shulman | Urology | Sovereign Medical Group LLC | 807 Kennedy Blvd, Suite A, Bayonne, NJ 07002-2983 |
| Albert O Kwon | Colorectal Surgery (proctology) | Sovereign Medical Group LLC | 15-01 Broadway Route 4 W, Suite 1, Fairlawn, NJ 07410-6006 |
| Andranik Howhannesian | Urology | Sovereign Medical Group LLC | 14 -01 Broadway, Suite 3, Fair Lawn, NJ 07410-2008 |
| Jerry Silver | Otolaryngology | Sovereign Medical Group LLC | 15 -01 Broadway Rt 4, Fairlawn, NJ 07410-6006 |
| Joel Abramowitz | Urology | Sovereign Medical Group LLC | 8100 Kennedy Blvd, North Bergen, NJ 07047-4254 |
| Richard Maggio | Urology | Sovereign Medical Group LLC | 2071 Clove Rd J, Staten Island, NY 10304-1612 |
| Scott A Goler | Podiatry | Sovereign Medical Group LLC | 265 E 33rd St, Paterson, NJ 07504-1668 |
| Morteza Shahamat | Internal Medicine | Sovereign Medical Group LLC | 400 Franklin Tpke, Suite 104, Mahwah, NJ 07430-3517 |
| Street Address |
265 E 33RD ST |
| City | PATERSON |
| State | NJ |
| Zip | 07504-1668 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Scott A Goler | Podiatry | Sovereign Medical Group LLC | 265 E 33rd St, Paterson, NJ 07504-1668 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Alvaro Tellez | Internal Medicine | 466 Park Ave, Paterson, NJ 07504-1806 | |
| Fred Revoredo | General Practice | 425 15th Ave, Suite 2, Paterson, NJ 07504-1811 | |
| Pudchong Srisethnil | Internal Medicine | 561 E 28th St, Paterson, NJ 07504-1862 | |
| Nidia Ortega | Family Medicine | Centro Medico Iberoamericano Inc. | 416 Park Ave, Paterson, NJ 07504-1930 |
| Melissa Amy Desueza | Nurse Practitioner | Centro Medico Iberoamericano Inc. | 416 Park Ave, Paterson, NJ 07504-1930 |
| Ramon A Sandoval | Internal Medicine | Centro Medico Iberoamericano Inc. | 416 Park Ave, Paterson, NJ 07504-1930 |
| Juan A Desueza | Internal Medicine | Centro Medico Iberoamericano Inc. | 416 Park Ave, Paterson, NJ 07504-1930 |
| City | PATERSON |
| Zip Code | 07504 |
| Specialty | PODIATRY |
| City + Specialty | PATERSON + PODIATRY |
Please comment or provide details below to improve the information on Daniel J Waltuch.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.