Jeanine Marie Potenza

Primary specialty

Respite CareTaxonomy code 385H00000X

License

00375093 Issued in NJ

Practice address

41 Fairmount Ave Apt 8B
Hackensack, NJ 07601-4747

Phone

(201) 478-1547

NPI assigned

Jul 20, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Teachable Moments of NJ

  • Developmental Disabilities Clinic/Center
  • Hackensack, NJ
  • NPI 1043735699
  NPD (past) Authorized official

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

{
    "created_epoch": "1500508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1295258333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1122",
            "city": "MAYWOOD",
            "state": "NJ",
            "postal_code": "076077122",
            "telephone_number": "201-478-1547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 FAIRMOUNT AVE APT 8B",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076014747",
            "telephone_number": "201-478-1547"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Spring Valley Ave",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076013801",
            "country_code": "US",
            "telephone_number": "201-478-1547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTENZA",
        "first_name": "JEANINE",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NJ",
            "license": "00375093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Pormento
• David Alexander Porter
• Katherine Porterfield, PA-C
• Harvy Ken Porzuelo, MD
• Linda Poskanzer, LCSW
• Suraj Pothineni, DO
• Jacqueline Powell, LCSW
• Luca Prada, PT, DPT
• Ankur Pradhan, MD
• Roman Prager, MD

• Respite Care in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Respite Care in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.