Michele Louise Deantonio, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MA48825 Issued in NJ

Practice address

160 Terrace St
Haworth, NJ 07641-1845

Phone

(201) 439-1200

Fax

(201) 439-1208

NPI assigned

Jul 9, 2006

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

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659304715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 TERRACE ST",
            "city": "HAWORTH",
            "state": "NJ",
            "postal_code": "076411845",
            "telephone_number": "201-439-1200",
            "fax_number": "201-439-1208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 TERRACE ST",
            "city": "HAWORTH",
            "state": "NJ",
            "postal_code": "076411845",
            "telephone_number": "201-439-1200",
            "fax_number": "201-439-1208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEANTONIO",
        "first_name": "MICHELE",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "MA48825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann M Anderson, R.N.,IBCLC
• Alisa Dawn Broizman, M.A.,CCC-SLP
• Camille F Burns, PHD
• David Benjamin Buzharsky
• Ilvira D'Atri, DPM
• Alida Ann Derussi, LCSW
• Doctors Home Visits LLC
• Victoria Dubin Master
• Janet Marie Fairbanks, M.D.
• Sari Fremont, LCSW, MSW

• Pediatrics Physician in Haworth, NJ
• Providers in Haworth, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.