Angela Eftychiadis, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

25MA06383000 Issued in NJ

Practice address

1 Malcolm Ave
Teterboro, NJ 07608-1011

Phone

(201) 393-5443

Fax

(201) 462-4199

NPI assigned

Dec 23, 2008

Last updated

Mar 13, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Christopher B. Kruse, M.D., LLC

  dba Dermatology and Skin Cancer Center

  • Dermatology Physician
  • Red Bank, NJ
  • NPI 1457598112
  Medicare reassignment NPD
• Bodian Medical Services of Forest Hills PC

  • Specialist
  • Forest Hills, NY
  • NPI 1043441777
  NPD (past)

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

{
    "created_epoch": "1229990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236902400000",
    "number": "1982840898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 PASSAIC AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071101752",
            "telephone_number": "201-393-5443",
            "fax_number": "201-462-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MALCOLM AVE",
            "city": "TETERBORO",
            "state": "NJ",
            "postal_code": "076081011",
            "telephone_number": "201-393-5443",
            "fax_number": "201-462-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EFTYCHIADIS",
        "first_name": "ANGELA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-23",
        "last_updated": "2009-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NI0002X",
            "taxonomy_group": "",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "NJ",
            "license": "25MA06383000",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NJ",
            "license": "25MA06383000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Costco Wholesale Corporation (Costco Hearing Aid #1214)
• County of Bergen
• Michael Denaro
• Xiomara Diaz Montanez
• Pasquale Dimaiolo
• Emmanuel B. Ekeh, PHARM.D.
• Caroline Mary Fischer
• Flexwellness of Teterboro
• Eugene Fulop, M.D.
• Leza N Gallo, M.D.

• Anatomic Pathology & Clinical Pathology Physician in Teterboro, NJ
• Providers in Teterboro, NJ by specialty
• Anatomic Pathology & Clinical Pathology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2009; 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.