MEDISOL, LLC (NPI# 1003279308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003279308 |
| Entity Type | Organization |
| Organization Name | MEDISOL, LLC |
| Practice Address |
226 Fisher Ave Piscataway NJ 08854-4833 |
| Mailing Address |
10201 Perkins Dr Irving TX 75063-5365 |
| Practice Telephone | 2144449864 |
| Mailing Telephone | 2144449864 |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2016-04-04 |
| Authorized Official Name | DR. TAHIR KHWAJA (PRESIDENT) |
| Authorized Official Telephone | 9172878207 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians |
| Street Address |
226 FISHER AVE |
| City | PISCATAWAY |
| State | NJ |
| Zip Code | 08854-4833 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992327548 | Sally Ng | Student in an Organized Health Care Education/Training Program | 675 Hoes Lane West, Piscataway, NJ 08854 | 2020-05-16 |
| 1932728870 | Mawaddah Ahmed Mohamed Khalil Alislambouli | Student in an Organized Health Care Education/Training Program | 1701 Quincy Street, Piscataway, NJ 08854 | 2020-04-10 |
| 1457831273 | Lindsay Brooke Gonzalez | Social Worker | Rutgers Day School- Rutgers University Ubhc, 671 Hoes Lane, Piscataway, NJ 08854 | 2018-08-21 |
| 1568941524 | Step Three Support Services, LLC | In Home Supportive Care | 1297 Centennial Ave Ste 5-102, Piscataway, NJ 08854 | 2018-08-10 |
| 1942788252 | Adrienne Wallace | Speech-Language Pathologist | 170 Birchview Dr, Piscataway, NJ 08854 | 2018-07-31 |
| 1215423066 | Eugene Reid | Physical Medicine & Rehabilitation | 250 Old New Brunswick Road, Building 12, Piscataway Township, NJ 08854 | 2018-07-05 |
| 1649768326 | Madhusree Chowdhury | Student in an Organized Health Care Education/Training Program | Rutgers Rwjms, 675 Hoes Lane, Piscataway, NJ 08854 | 2018-04-27 |
| 1033635065 | Achieving Goals, LLC | Community Health Worker | 83 Kensington Drive, Piscataway, NJ 08854 | 2017-08-22 |
| 1750801650 | Neil O'connor | Case Manager/Care Coordinator | 151 Centenial Ave, Piscataway, NJ 08854 | 2017-06-21 |
| 1235680240 | Manthan Patel | Pharmacist | 1222 Hanover St, Piscataway, NJ 08854 | 2016-10-14 |
| Find all providers in zip 08854 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386051860 | Shawen Maryrose Ilaria | Psychiatry & Neurology | 671 Hoes Ln W, Piscataway, NJ 08854-8021 | 2014-07-16 |
| 1720239023 | Raymond Ee-mook Chong | Psychiatry & Neurology | 671 Hoes Ln W, Piscataway, NJ 08854-8021 | 2008-10-06 |
| 1942218607 | Sherie Lynn Novotny | Psychiatry & Neurology | 671 Hoes Ln W, Rm D439, Piscataway, NJ 08854-8021 | 2006-08-04 |
| 1033170121 | Theodore A Petti | Psychiatry & Neurology | 671 Hoes Ln, University Behavioral Healthcare Room C-202, Piscataway, NJ 08854-5627 | 2006-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063059079 | Rr & C Associates | Psychiatry & Neurology | 705 Birchfield Dr, Mount Laurel, NJ 08054-4013 | 2019-12-09 |
| 1154888162 | St. Luke's Counseling Medical Center L.L.C. | Psychiatry & Neurology | 59 Seeley Ave, Kearny, NJ 07032-3120 | 2019-02-26 |
| 1194297614 | Childpsych Services, LLC | Psychiatry & Neurology | 940 Cedar Bridge Ave Fl 2, Brick, NJ 08723-4170 | 2018-12-21 |
| 1043637465 | Jason Dean | Psychiatry & Neurology | 400 Frank W Burr Blvd # 6, Teaneck, NJ 07666-6839 | 2014-03-24 |
| 1184963837 | Prospect Psychiatric Services Limited Liability Company | Psychiatry & Neurology | 344 Prospect Ave Apt 1a, Hackensack, NJ 07601-2602 | 2013-01-31 |
| 1174870034 | Naomi Ambalu | Psychiatry & Neurology | 266 King George Rd Ste G, Warren, NJ 07059-5187 | 2012-08-10 |
| 1699022558 | Nanda Muthusawmy | Psychiatry & Neurology | 210 Malapardis Rd Ste 205, Cedar Knolls, NJ 07927 | 2012-08-10 |
| 1144512674 | Magalie Saint-lot Jacques | Psychiatry & Neurology | 31 Bridgewater Ct, Jackson, NJ 08527-4030 | 2011-05-03 |
| 1043501265 | Kathreen Tharwat Tadrous | Psychiatry & Neurology | 655 E. Jersey Sreet, Trinitas Regional Medical Center, Elizabeth, NJ 07206 | 2011-04-21 |
| 1760792402 | Deepti-sagar Varma | Psychiatry & Neurology | 210 Bellevue Avenue, Upper Montclair, NJ 07043 | 2010-10-15 |
| Find all providers with the same taxonomy | ||||
| City | PISCATAWAY |
| Zip Code | 08854 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.