Paul Fontanazza, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

32061 Issued in NJ

Practice address

450 Bergen St
Harrison, NJ 07029

Phone

(973) 484-6900

Fax

(973) 484-0029

NPI assigned

Aug 14, 2006

Last updated

Mar 7, 2023By the provider in NPPES

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

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1225041965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 BERGEN ST",
            "city": "HARRISON",
            "state": "NJ",
            "postal_code": "07029",
            "telephone_number": "973-484-6900",
            "fax_number": "973-484-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 BERGEN ST",
            "city": "HARRISON",
            "state": "NJ",
            "postal_code": "07029",
            "telephone_number": "973-484-6900",
            "fax_number": "973-484-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTANAZZA",
        "first_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "32061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDS",
            "identifier": "D02037000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emely Caroline Escuza
• Amanda Kelly Fabri, DPT
• Henrique Fernandes, PA
• Angelica Fiuza
• Rosemarie Flom Cisneros, LAC
• Jon Alexander Frawley
• Jamie Fugowski, DPT, ATIRC
• Melanie Gave, DPT
• Liamne Gerardo Franco, DMD
• Kevin Nicholas Giunta, D.C.

• Internal Medicine Physician in Harrison, NJ
• Providers in Harrison, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.