| Elizabeth Jacob, | |
|
223 N Van Dien Ave Dept Of, Ridgewood, NJ 07450-2726 | |
| (201) 447-8000 | |
| Not Available |
| Full Name | Elizabeth Jacob |
|---|---|
| Gender | Female |
| Speciality | Surgery |
| Location | 223 N Van Dien Ave Dept Of, Ridgewood, New Jersey |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619408234 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 25MA11829800 (New Jersey) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| Entity Name | Valley Physician Services Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467815928 PECOS PAC ID: 3577857333 Enrollment ID: O20160802002824 |
| Mailing Address | Practice Location Address |
|---|---|
| Elizabeth Jacob, 223 N Van Dien Ave Dept Of, Ridgewood, NJ 07450-2726 Ph: () - | Elizabeth Jacob, 223 N Van Dien Ave Dept Of, Ridgewood, NJ 07450-2726 Ph: (201) 447-8000 |
Mary Ann Benigno, DO Surgery Medicare: Accepting Medicare Assignments Practice Location: 145 Prospect Street, Ridgewood, NJ 07450 Phone: 201-368-3699 Fax: 201-368-9633 | |
Dr. Chidambaram Raman, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1200 E Ridgewood Ave, West Wing, 2nd Floor, Ridgewood, NJ 07450 Phone: 201-444-4466 Fax: 201-444-6672 | |
Dr. Joshua William Bernheim, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1200 E Ridgewood Ave, West Wing 2nd Floor, Ridgewood, NJ 07450 Phone: 201-444-5353 Fax: 201-444-8848 | |
Dr. Anthony Enrico Pucci, D.O. Surgery Medicare: Not Enrolled in Medicare Practice Location: 61 N Maple Ave, Suite 205, Ridgewood, NJ 07450 Phone: 201-447-2808 Fax: 201-447-2809 | |
Edward A Pucci, D.O. Surgery Medicare: Not Enrolled in Medicare Practice Location: 61 N Maple Ave, Suite 205, Ridgewood, NJ 07450 Phone: 201-447-2808 Fax: 201-447-2809 | |
Dr. Archana Raman, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1200 E Ridgewood Ave Ste 203, Ridgewood, NJ 07450 Phone: 201-444-4466 | |
Dr. Daniel Char, Surgery Medicare: Accepting Medicare Assignments Practice Location: 1200 E Ridgewood Ave, Ridgewood, NJ 07450 Phone: 201-444-5353 |