Paonessa Colon and Rectal Surgery, P.C.
Organization Active NPI Surgery Physician · Brielle, NJ
NPI 1962827949 · NPPES record last updated May 9, 2019
Key facts
- NPI
- 1962827949
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- Legal business name
- PAONESSA COLON AND RECTAL SURGERY, P.C.
- Practice address
- 603 Higgins Ave
Brielle, NJ 08730-1476 - Phone
- (732) 282-1500
- Fax
- (732) 282-1501
- NPI assigned
- Feb 27, 2014
- Organization subpart
- No
Authorized official
- Name
- Dr. Nina Paonessa, DO
- Title
- Owner
- Phone
- (732) 282-1500
Practitioners 2
-
Nina J Paonessa, D.O., F.A.C.O.S
-
Robert Warren Deatrick II, D.D.S
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140710001406 | NJ | Part B Supplier - Clinic/Group Practice | 1850516691 |
Receives reassigned benefits from 1 practitioner Practice locations: Brielle, NJ |
National Provider Directory
Locations
603 Higgins Ave
Brielle, NJ 08730
Phone (732) 282-1500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician |
208600000X | Yes |
Addresses
Primary practice location
603 Higgins Ave
Brielle, NJ 08730-1476
Mailing address
603 Higgins Ave
Brielle, NJ 08730-1476
Phone (732) 282-1500
Other providers in Brielle, NJ
- Jennifer Elizabeth Noble
- Sharon O'Brien
- Kristin Mischler O'Gara
- Anthony T. Palisi
- Roseanne M Palladino
- Nina J Paonessa
- Armine L Papazian
- Maryellen Parcero
- Jennifer Pearlman
- Jessica M Pesce
All providers in Brielle, NJ · Surgery Physician 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 May 9, 2019. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.