Diabetes, Endocrinology, Metabolism, Specialities, P.a.

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

MA39378 Issued in NJ

Legal business name

DIABETES, ENDOCRINOLOGY, METABOLISM, SPECIALITIES, P.A.

Practice address

870 Palisade Ave
Teaneck, NJ 07666-3419

Phone

(201) 836-5655

Fax

(201) 836-3571

NPI assigned

Feb 7, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mark Wiesen, M.D.

Title

President

Phone

(201) 836-5655

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Donna Yannacone, MS, RD, CDE

  • Registered Dietitian
  • Clifton, NJ
  • NPI 1902963168
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003956491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 PALISADE AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663419",
            "telephone_number": "201-836-5655",
            "fax_number": "201-836-3571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 PALISADE AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663419",
            "telephone_number": "201-836-5655",
            "fax_number": "201-836-3571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETES, ENDOCRINOLOGY, METABOLISM, SPECIALITIES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WIESEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-836-5655",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "MA39378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shalin P. Desai, M.D.
• Neelangani Therese Desoyza, MD
• Jessica Deuble, OTR
• Paul Deutsch, MD
• Devi Care, Inc. (Home Instead Senior Care)
• Ambar Rosinna Diaz
• Anny Marie Diaz, LCSW
• Jasmine Diaz, LCSW
• Tomas Diaz
• Nicole Dipaola, SLP

• Endocrinology, Diabetes & Metabolism Physician in Teaneck, NJ
• Providers in Teaneck, NJ by specialty
• Endocrinology, Diabetes & Metabolism Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.