| Valentyna Tack, DO | |
|
101 Old Short Hills Rd Ste 105, West Orange, NJ 07052-1080 | |
| (973) 325-1115 | |
| (973) 325-1186 |
| Full Name | Valentyna Tack |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 101 Old Short Hills Rd Ste 105, West Orange, 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 |
|---|---|---|---|
| 1235628850 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | DO035019 (District Of Columbia) | Secondary |
| 208000000X | Pediatrics | 25MB11903400 (New Jersey) | Primary |
| Entity Name | Childrens Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912939703 PECOS PAC ID: 0244143170 Enrollment ID: O20031107000130 |
| Mailing Address | Practice Location Address |
|---|---|
| Valentyna Tack, DO 401 Route 73 N Bldg 10, Suite 320, Marlton, NJ 08053 Ph: (973) 325-1115 | Valentyna Tack, DO 101 Old Short Hills Rd Ste 105, West Orange, NJ 07052-1080 Ph: (973) 325-1115 |
Dr. Erik Dienna, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 745 Northfield Ave Ste 7, West Orange, NJ 07052 Phone: 973-243-0002 Fax: 855-274-7153 | |
Dr. Svetlana Lantsman Sabel, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 375 Mount Pleasant Ave Ste 105, West Orange, NJ 07052 Phone: 973-322-6900 Fax: 973-322-6999 | |
Dr. Susan Sonhe Yoo, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 101 Old Short Hills Rd Ste 105, West Orange, NJ 07052 Phone: 973-325-1115 Fax: 973-325-1186 | |
Stephen Amaefuna, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 4 Faas Ct, West Orange, NJ 07052 Phone: 973-715-2688 Fax: 973-324-9725 | |
Dr. Constantinos Kintiroglou, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1500 Pleasant Valley Way, Ste 306, West Orange, NJ 07052 Phone: 973-243-0002 Fax: 973-243-1227 | |
Marianne Jacob, Pediatrics Medicare: Medicare Enrolled Practice Location: 375 Mount Pleasant Ave, West Orange, NJ 07052 Phone: 973-322-6900 Fax: 973-322-6999 |