| Essentiamd | |
|
587 Westminster Ave Ofc Elizabeth NJ 07208-2206 | |
| (973) 483-6800 | |
| (201) 645-3787 |
| Full Name | Essentiamd |
|---|---|
| Speciality | Internal Medicine |
| Location | 587 Westminster Ave Ofc, Elizabeth, New Jersey |
| Authorized Official Name and Position | Flavia Annette De La Cruz (CEO) |
| Authorized Official Contact | 9734836800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Essentiamd 48 Verbickas Dr Woodland Park NJ 07424-3720 Ph: (973) 483-6800 | Essentiamd 587 Westminster Ave Ofc Elizabeth NJ 07208-2206 Ph: (973) 483-6800 |
| NPI Number | 1184025595 |
|---|---|
| Provider Enumeration Date | 09/05/2014 |
| Last Update Date | 01/24/2022 |
| Medicare PECOS PAC ID | 1951704055 |
|---|---|
| Medicare Enrollment ID | O20210727003231 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184025595 | NPI | - | NPPES |
| 0309826 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25MA08833900 (New Jersey) | Primary |
| Provider Name | Flavia A De La Cruz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538390950 PECOS PAC ID: 1759564321 Enrollment ID: I20110321000515 |
| Provider Name | Marie Perkowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356686059 PECOS PAC ID: 9931340908 Enrollment ID: I20130802000586 |
| Provider Name | Susan Meyeno Omoregie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578926697 PECOS PAC ID: 6608165543 Enrollment ID: I20160517001687 |
| Provider Name | Danielle L Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801312152 PECOS PAC ID: 3779840251 Enrollment ID: I20171208001850 |
| Provider Name | Danielle Trenelli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558803676 PECOS PAC ID: 2769734268 Enrollment ID: I20181011000447 |
| Provider Name | Murla Ecclesiaste |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861820235 PECOS PAC ID: 3072742345 Enrollment ID: I20190116003077 |
| Provider Name | Judith A Connell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780157313 PECOS PAC ID: 0941549349 Enrollment ID: I20190301000978 |
| Provider Name | Natacha Jharahy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275151961 PECOS PAC ID: 5890161699 Enrollment ID: I20221019002365 |
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