| Medvance LLC | |
|
214 Oak St Ridgewood NJ 07450-2511 | |
| (484) 288-8130 | |
| Not Available |
| Full Name | Medvance LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 214 Oak St, Ridgewood, New Jersey |
| Authorized Official Name and Position | Gazala Dave (OWNER) |
| Authorized Official Contact | 4842888130 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medvance LLC 214 Oak St Ridgewood NJ 07450-2511 | Medvance LLC 214 Oak St Ridgewood NJ 07450-2511 Ph: (484) 288-8130 |
| NPI Number | 1801369582 |
|---|---|
| Provider Enumeration Date | 01/06/2019 |
| Last Update Date | 01/02/2021 |
| Certification Date | 01/02/2021 |
| Medicare PECOS PAC ID | 9133533441 |
|---|---|
| Medicare Enrollment ID | O20210128000237 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801369582 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Gazala Dave |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467745695 PECOS PAC ID: 4385888064 Enrollment ID: I20140723001569 |
| Provider Name | Ashlen Michal Kakolewski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972016301 PECOS PAC ID: 4385903079 Enrollment ID: I20180126000909 |
| Provider Name | Allyson Lynn Kubs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538931811 PECOS PAC ID: 2264876440 Enrollment ID: I20240215001382 |
| Provider Name | Esjona Mimini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568339497 PECOS PAC ID: 0941777437 Enrollment ID: I20260422000295 |
Gastrointestinal Associates PA Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 140 Chestnut St, Ridgewood, NJ 07450 Phone: 201-444-2600 Fax: 201-444-9471 |
Medical Centers of Northern New Jersey, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 195 S Maple Ave, Ridgewood, NJ 07450 Phone: 973-953-8105 Fax: 770-643-2011 |
Design Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 127 Union St Ste 105, Ridgewood, NJ 07450 Phone: 973-321-1670 Fax: 973-321-1672 |
Hackensack Infectious Disease Associates, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 311 S Irving St, Ridgewood, NJ 07450 Phone: 908-464-3636 Fax: 908-464-6711 |
Anna M. Korkis MD PA Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 206 Dayton St, Ridgewood, NJ 07450 Phone: 201-444-0009 Fax: 201-444-2181 |
Ridgewood Vein & Laser Center LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 38 Oak St, Ridgewood, NJ 07450 Phone: 914-445-4410 |