Noel Wiederhorn, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA02569900 Issued in NJ

Practice address

43 Yawpo Ave
Oakland, NJ 07436-2714

Phone

(201) 405-0500

Fax

(201) 337-5585

NPI assigned

Aug 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16399/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358467200000",
    "number": "1093716359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 PALISADE AVE",
            "address_2": "STE 204",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663419",
            "telephone_number": "201-928-1093",
            "fax_number": "201-928-0842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 YAWPO AVE",
            "city": "OAKLAND",
            "state": "NJ",
            "postal_code": "074362714",
            "telephone_number": "201-405-0500",
            "fax_number": "201-337-5585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDERHORN",
        "first_name": "NOEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2013-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA02569900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1414801",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kiersten Weber, CNN
• Harvey Fred Weiss, O.D.
• Jeffrey Wells, DC
• Jade Chinesse West, COTA/L
• Bradford Whiteley
• William K Lee MD PA
• Chantal G Williams, MASSAGE THERAPIST
• Diane Margaret Wirth, L.C.S.W.
• Lisa K Zarb, PT
• Anna Maria Zdulska, PHARMD

• Pediatrics Physician in Oakland, NJ
• Providers in Oakland, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2013; 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.