| Holy Name Medical Associates, Pc | |
|
718 Teaneck Rd Teaneck NJ 07666-4245 | |
| (201) 833-3000 | |
| (201) 227-6207 |
| Full Name | Holy Name Medical Associates, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 718 Teaneck Rd, Teaneck, New Jersey |
| Authorized Official Name and Position | Patricia Beniquez Pacheco (CREDENTIALING SUPERVISOR) |
| Authorized Official Contact | 2018333599 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Holy Name Medical Associates, Pc 3 University Plz Ste 205 Hackensack NJ 07601-6208 Ph: (201) 833-3599 | Holy Name Medical Associates, Pc 718 Teaneck Rd Teaneck NJ 07666-4245 Ph: (201) 833-3000 |
| NPI Number | 1427407600 |
|---|---|
| Provider Enumeration Date | 06/08/2016 |
| Last Update Date | 05/08/2024 |
| Medicare PECOS PAC ID | 9436442712 |
|---|---|
| Medicare Enrollment ID | O20160725000868 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427407600 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Payal Shah |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1962406504 PECOS PAC ID: 7214820992 Enrollment ID: I20040205000973 |
| Provider Name | John D Frattarola |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609836592 PECOS PAC ID: 2365518487 Enrollment ID: I20080913000001 |
| Provider Name | George M Ajjan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992709521 PECOS PAC ID: 8224921606 Enrollment ID: I20100604000611 |
| Provider Name | Nicole L Palomar |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417204645 PECOS PAC ID: 6002038783 Enrollment ID: I20141113000222 |
| Provider Name | Johanna B Lee |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588076756 PECOS PAC ID: 2264788744 Enrollment ID: I20180713001772 |
| Provider Name | Adinah Wieder |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497121230 PECOS PAC ID: 6507192374 Enrollment ID: I20190731003820 |
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