New Jersey Endovascular Therapeutics PC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

NEW JERSEY ENDOVASCULAR THERAPEUTICS PC

Practice address

1200 E Ridgewood Ave
Ridgewood, NJ 07450-3957

Phone

(201) 444-5353

NPI assigned

Jun 6, 2007

Last updated

Jul 18, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Daniel CharNPI 1366518128

Title

President

Phone

(201) 444-5353

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daniel Char

  • Vascular Surgery Physician
  • Ridgewood, NJ
  • NPI 1366518128
  Medicare reassignment Care Compare group NPD Authorized official
• Joshua William Bernheim, M.D.

  • Vascular Surgery Physician
  • Ridgewood, NJ
  • NPI 1255375374
  Medicare reassignment Care Compare group NPD
• Maria Tenebruso, PA-C

  • Physician Assistant
  • Oakland, NJ
  • NPI 1184683088
  Medicare reassignment
• Tsui Yuen, PA

  • Physician Assistant
  • Bronx, NY
  • NPI 1700836020

  NJ

  Medicare reassignment
• Thomas Nesbitt Ahlborn, M.D.

  • Surgery Physician
  • Glen Rock, NJ
  • NPI 1801883277
  NPD (past)
• Mitul Suresh Patel, M.D.

  • Vascular Surgery Physician
  • Woodcliff Lake, NJ
  • NPI 1093045197
  NPD (past)

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184716800000",
    "number": "1467655662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CARRINGTON CT",
            "city": "WOODCLIFF LAKE",
            "state": "NJ",
            "postal_code": "076777855",
            "telephone_number": "201-444-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E RIDGEWOOD AVE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503957",
            "telephone_number": "201-444-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW JERSEY ENDOVASCULAR THERAPEUTICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2007-07-18",
        "status": "A",
        "authorized_official_last_name": "CHAR",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-444-5353"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Vascular Surgery Physician in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Vascular Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.