Individual provider Active NPI

Neal Dana Gittleman, M.D.

  • Pediatrics Physician
  • Lakewood, NJ
National Provider Identifier
1255379772
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MA51323 Issued in NJ
Practice address
450 E Kennedy Blvd
Lakewood, NJ 08701-1435
Phone
(732) 901-0050
Fax
(732) 370-2386
NPI assigned
Jun 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MA51323 NJ Primary

Addresses

Primary practice location

450 E Kennedy Blvd
Lakewood, NJ 08701-1435

Mailing address

450 E Kennedy Blvd
Lakewood, NJ 08701-1435
Phone (732) 901-0050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA51323NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocare , LLC Pediatrics Past Accepting new patients
Neal Gittleman, MD and Associates Pediatrics Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1255379772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 E KENNEDY BLVD",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087011435",
            "telephone_number": "732-901-0050",
            "fax_number": "732-370-2386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 E KENNEDY BLVD",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087011435",
            "telephone_number": "732-901-0050",
            "fax_number": "732-370-2386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GITTLEMAN",
        "first_name": "NEAL",
        "middle_name": "DANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "MA51323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; 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.