| Riddle Medical Llc | |
|
401 Sylvan Pl Haworth NJ 07641-1729 | |
| (201) 618-1818 | |
| Not Available |
| Full Name | Riddle Medical Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 401 Sylvan Pl, Haworth, New Jersey |
| Authorized Official Name and Position | Albert Riddle (OWNER) |
| Authorized Official Contact | 2016181818 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Riddle Medical Llc Po Box 29 Haworth NJ 07641-0029 Ph: (201) 512-9494 | Riddle Medical Llc 401 Sylvan Pl Haworth NJ 07641-1729 Ph: (201) 618-1818 |
| NPI Number | 1245286640 |
|---|---|
| Provider Enumeration Date | 05/26/2006 |
| Last Update Date | 11/20/2013 |
| Medicare PECOS PAC ID | 7113937103 |
|---|---|
| Medicare Enrollment ID | O20091030000340 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245286640 | NPI | - | NPPES |
| 02752096 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | MA177617 (New Jersey) | Primary |
| Provider Name | Albert L Riddle |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1699724880 PECOS PAC ID: 7113819962 Enrollment ID: I20040326000381 |
| Provider Name | Antonetta L Antonazzo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518959303 PECOS PAC ID: 8820004823 Enrollment ID: I20060228000798 |
| Provider Name | Katerina Listopad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790146744 PECOS PAC ID: 3870884190 Enrollment ID: I20160616001901 |
| Provider Name | Sheri A Riker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245789841 PECOS PAC ID: 9436433794 Enrollment ID: I20170306000157 |
| Provider Name | Salome G. Brown-burrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700317641 PECOS PAC ID: 8123379823 Enrollment ID: I20181022000070 |
| Provider Name | Eric Paolilli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326521741 PECOS PAC ID: 9638503246 Enrollment ID: I20200107000236 |
| Provider Name | Cheryl Pollidore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316266745 PECOS PAC ID: 1951710136 Enrollment ID: I20210430000087 |
Doctors Home Visits Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 296 Garfield Street, Haworth, NJ 07641 Phone: 201-384-3733 Fax: 201-384-8251 |