Theresa M Gelzinis-Enoch, RN

Primary specialty

Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X

License

26NR09559300 Issued in NJ

Practice address

10 Somerdale Square
1200 South White Horse Pike
Somerdale, NJ 08083-1345

Phone

(855) 740-1921

NPI assigned

Mar 9, 2021

Sex

Female

Sole proprietor

No

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

Credentials

Registered Nurse

State licenses

Practice roles

Locations

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.

• Bravo Medical, LLC

  • Methadone Clinic
  • Somerdale, NJ
  • NPI 1427602960
  NPD

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

{
    "created_epoch": "1615248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1346835683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 RENAISSANCE BLVD FL 4",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062781",
            "telephone_number": "484-803-9663",
            "fax_number": "484-393-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SOMERDALE SQUARE",
            "address_2": "1200 SOUTH WHITE HORSE PIKE",
            "city": "SOMERDALE",
            "state": "NJ",
            "postal_code": "080831345",
            "telephone_number": "855-740-1921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELZINIS-ENOCH",
        "first_name": "THERESA",
        "middle_name": "M",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-09",
        "last_updated": "2021-03-09",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "26NR09559300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Forbes
• Amanda Ann Forman, DPT
• Friends of Cyrus II
• Samantha Helen Galson, MA, LPC, LCPC,LCMHC
• Kassandra Nahomy Garcia-Giron
• Jane Susan Ginsburg, LPT
• Gofer Transportation
• Shyna Grimberg
• Stephen John Hall
• Kim Harper, RN

• Addiction (Substance Use Disorder) Registered Nurse in Somerdale, NJ
• Providers in Somerdale, NJ by specialty
• Addiction (Substance Use Disorder) Registered Nurse in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; 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.