Individual provider Active NPI

Eleanor A Gonnella, MD

  • Internal Medicine Physician
  • Rutherford, NJ
National Provider Identifier
1255432688
Registry record updated Mar 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA04298900 Issued in NJ
Practice address
47 Orient Way
Suite 3B
Rutherford, NJ 07070
Phone
(201) 939-2826
Fax
(201) 939-0562
NPI assigned
Sep 26, 2006
Last updated
Mar 10, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA04298900 NJ Primary

Addresses

Primary practice location

47 Orient Way
Suite 3B
Rutherford, NJ 07070

Mailing address

47 Orient Way
Suite 3B
Rutherford, NJ 07070
Phone (201) 939-2826

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA04298900NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268179200000",
    "number": "1255432688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 ORIENT WAY",
            "address_2": "SUITE 3B",
            "city": "RUTHERFORD",
            "state": "NJ",
            "postal_code": "07070",
            "telephone_number": "201-939-2826",
            "fax_number": "201-939-0562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 ORIENT WAY",
            "address_2": "SUITE 3B",
            "city": "RUTHERFORD",
            "state": "NJ",
            "postal_code": "07070",
            "telephone_number": "201-939-2826",
            "fax_number": "201-939-0562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONNELLA",
        "first_name": "ELEANOR",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2010-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA04298900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutherford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2010; 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.