DR. MARIO CHARLES COLLETTI (NPI# 1043449671) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043449671 |
| Entity Type | Individual |
| Full Name | DR. MARIO CHARLES COLLETTI |
| Credential | M.D. |
| Practice Address |
703 Main St Paterson NJ 07503 |
| Mailing Address |
7 Berry Dr Wayne NJ 07470-3812 |
| Practice Telephone | 9739724300 |
| Mailing Telephone | 6317676552 |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2018-06-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
25MA10146800 | NJ | Allopathic & Osteopathic Physicians |
| Street Address |
703 MAIN ST |
| City | PATERSON |
| State | NJ |
| Zip Code | 07503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831192269 | Subhashree Datta Bhutada | Pediatrics | 703 Main St, Paterson, NJ 07503-2621 | 2005-05-31 |
| 1629684048 | Michelle Szerling | Nurse Practitioner | 703 Main St, Paterson, NJ 07503-2621 | 2020-09-21 |
| 1851905822 | Ijeoma Christiana Onyeagocha | Nurse Practitioner | 703 Main St, Paterson, NJ 07503-2621 | 2020-09-07 |
| 1518571868 | Prathyusha Chennupati | Student in an Organized Health Care Education/Training Program | 703 Main St, Paterson, NJ 07503-2621 | 2020-09-03 |
| 1639782030 | Claudio Sam Santos | Nurse Practitioner | 703 Main St, Paterson, NJ 07503-2621 | 2020-08-25 |
| 1720690688 | Sewar Hisham Abuarqob | Student in an Organized Health Care Education/Training Program | 703 Main St, Paterson, NJ 07503-2621 | 2020-08-20 |
| 1336750413 | Trixie Kioko-kamps | Midwife | 703 Main St, Paterson, NJ 07503-2621 | 2020-08-12 |
| 1548870538 | Kristina Scott | Dietitian, Registered | 703 Main St, Paterson, NJ 07503-2621 | 2020-08-04 |
| 1972112530 | Devon Marie Cavazos | Social Worker | 703 Main St, Paterson, NJ 07503-2691 | 2020-07-29 |
| 1225656408 | Dinesh Parmar | Student in an Organized Health Care Education/Training Program | 703 Main St, Paterson, NJ 07503-2621 | 2020-07-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669001426 | Kevin Vasquez | Student in an Organized Health Care Education/Training Program | St. Joseph's University Medical Hospital 703 Main St, Paterson, NJ 07503 | 2020-04-03 |
| 1689210346 | Denisa Stojakova | Internal Medicine | 37 Crooks Ave Ste 43, Paterson, NJ 07503 | 2019-11-18 |
| 1295206563 | Safa Travel LLC | Taxi | 205 Illinois Ave Fl 2, Paterson, NJ 07503 | 2018-12-16 |
| 1740780980 | Icp2 LLC | Pharmacy | 661main Street, Paterson, NJ 07503 | 2018-02-14 |
| 1194224329 | Reliable Laboratory | Clinical Medical Laboratory | 37 Crooks Avenue #43, Paterson, NJ 07503 | 2018-02-02 |
| 1487178703 | Field of Vision Services, LLC | Community/Behavioral Health | 235 Dakota St. Unit 1, Paterson, NJ 07503 | 2017-07-28 |
| 1982125043 | Saera Watanabe | Student in an Organized Health Care Education/Training Program | 703 Main Street, St. Joseph's Regional Medical Center, Department of Pediatrics, Paterson, NJ 07503 | 2017-06-29 |
| 1396266680 | Tulip Obgyn LLC | Obstetrics & Gynecology | 991 Main St Ste 2b, Paterson, NJ 07503 | 2017-06-28 |
| 1194251421 | Straight and Narrow, Inc | Substance Abuse Rehabilitation Facility | 410 Straight Street, Paterson, NJ 07503 | 2017-05-05 |
| 1083160956 | St. Josephs Regional Medical Center | Student in an Organized Health Care Education/Training Program | 400 Hospital Plaza, Paterson, NJ 07503 | 2016-08-30 |
| Find all providers in zip 07503 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457353757 | Willaim J Debruin | Pediatrics | 703 Main St, Paterson, NJ 07503-2621 | 2005-06-01 |
| 1285636563 | Barbara M Cocovinis | Pediatrics | 703 Main St, Paterson, NJ 07503-2621 | 2005-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821174558 | Meena Kalyanaraman | Pediatrics | 201 Lyons Ave # C-5, Newark, NJ 07112-2027 | 2006-10-27 |
| 1376956946 | Rachel Lewis | Pediatrics | 30 Prospect Ave, Picu, Hackensack, NJ 07601-1915 | 2014-06-11 |
| 1568705051 | Maria Luisa Escobar | Pediatrics | 100 Madison Ave, Morristown, NJ 07960-6136 | 2013-04-03 |
| 1528326980 | Amy L. Chirico | Pediatrics | 30 Prospect Ave, Hackensack, NJ 07601 | 2012-04-24 |
| 1134421530 | Abigail Hodges Walsh | Pediatrics | 94 Old Short Hills Rd, Livingston, NJ 07039 | 2010-11-17 |
| 1356671887 | Colin Russell O'reilly | Pediatrics | 200 Somerset St, New Brunswick, NJ 08901-1942 | 2010-01-06 |
| 1396074456 | Michael Keenaghan | Pediatrics | 100 Madison Ave, Morristown, NJ 07960-6136 | 2009-12-17 |
| 1104060102 | Amit C Misra | Pediatrics | 300 Second Avenue, Long Branch, NJ 07740 | 2009-04-22 |
| 1952544272 | Ma. Bernardita Ricafort Gamallo | Pediatrics | 100 Madison Ave, Morristown, NJ 07960-6136 | 2009-04-16 |
| 1780831867 | Sumon Kumar Das | Pediatrics | 201 Lyons Ave, Ste C5, Newark, NJ 07112-2027 | 2008-08-20 |
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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.