Michele D Haviland, PNPC
Individual provider Active NPI Pediatric Nurse Practitioner · Elmwood Park, NJ
NPI 1336219963 · NPPES record last updated Nov 1, 2021
Key facts
- NPI
- 1336219963
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- 26NN09740700 (NJ)
- Practice address
- 241 Molnar Dr Ste 202
Elmwood Park, NJ 07407-3200 - Phone
- (201) 578-4147
- Fax
- (877) 553-1385
- NPI assigned
- Nov 9, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211104001014 | NJ | Practitioner - Nurse Practitioner | 0840688214 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 381199 | NY | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advocare , LLC | Current |
Accepting new patients | |
| Advocare , LLC | Current |
Accepting new patients | |
| Advocare, LLC | Current |
Accepting new patients | |
| Advocare, LLC | Past |
Accepting new patients | |
| Advocare, LLC | Past | Accepting new patients |
Locations
169 Mine Brook Rd
#P
Bernardsville, NJ 07924
Phone (908) 766-0034
241 Molnar Dr
Ste 202
Elmwood Park, NJ 07407
Phone (201) 578-4147
132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211
401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033
948 Teaneck Rd
Teaneck, NJ 07666
Phone (201) 836-2720
Interoperability endpoints
- mhaviland838978@nychhc.direct-ci.com
- michele.haviland@advocaredoctors.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 381199 | NY | |
| Pediatric Nurse Practitioner | 363LP0200X | 26NN09740700 | NJ | Yes |
Addresses
Primary practice location
241 Molnar Dr Ste 202
Elmwood Park, NJ 07407-3200
Mailing address
831 Woodland Ave
Oradell, NJ 07649-1431
Phone (201) 986-0741
Other practice location 1
3424 Kossuth Ave
Bronx, NY 10467-2410
Phone (718) 519-3015
Other providers in Elmwood Park, NJ
- Sheldon H. Greenspan
- Arielle Leah Gromack
- Pushpa Gupta
- Jasmin Harounian
- Sean Barrington Harrow Sr.
- Health One Medical & Physical Rehabilitation LLC
- Tamia Nicole Henry
- Matthew Alexander Hernandez
- Hma Medical Suppliers
- Katie Hoang
All providers in Elmwood Park, NJ · Pediatric Nurse Practitioner in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.