DONNA NICKLES (NPI# 1063400547) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063400547 |
| Entity Type | Individual |
| Full Name | DONNA NICKLES |
| Practice Address |
80 Eisenhower Dr Suite 200 Paramus NJ 07652-1401 |
| Practice Telephone | 2018432800 |
| Practice Fax Number | 9739390273 |
| Mailing Telephone | 2018432800 |
| Mailing Fax Number | 9739390273 |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2017-04-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 25MB03792500 | NJ | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | AMERIHEALTH # | 0105583000 | 01 |
| NJ | HEALTHNET # | 1K4890 | 01 |
| NJ | AETNA HMO # | 2807666 | 01 |
| NJ | RAILROAD MCR # | 160055692 | 01 |
| NJ | OXFORD # | P2631203 | 01 |
| NJ | EMPIRE BCBS # | 39F312 | 01 |
| NJ | AETNA PPO # | 4252756 | 01 |
| Street Address |
80 EISENHOWER DR SUITE 200 |
| City | PARAMUS |
| State | NJ |
| Zip Code | 07652-1401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487905246 | Grace Ruth Qarmout | Nurse Practitioner | 80 Eisenhower Dr, Suite 200, Paramus, NJ 07652-1430 | 2012-09-19 |
| 1396009346 | Paramus Endoscopy LLC | Clinic/Center | 80 Eisenhower Dr, Paramus, NJ 07652-1430 | 2012-06-25 |
| 1609948793 | Jennifer Nash | Nurse Practitioner | 80 Eisenhower Dr, Paramus, NJ 07652-1401 | 2006-11-14 |
| 1740202845 | Endoscopy Center of Bergen County, LLC | Clinic/Center | 80 Eisenhower Dr, Paramus, NJ 07652-1401 | 2006-07-25 |
| 1437194180 | Valley Ob & Gyn Assoc P A | Specialist | 80 Eisenhower Dr, Suite 200, Paramus, NJ 07652-1401 | 2006-06-17 |
| 1033159124 | Katherine Obrien | Obstetrics & Gynecology | 80 Eisenhower Dr, Suite 200, Paramus, NJ 07652-1430 | 2006-06-07 |
| 1871581363 | Thomas Russo | Specialist | 80 Eisenhower Dr, Suite 200, Paramus, NJ 07652-1401 | 2005-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750997789 | Eunice Ramos | Nurse Practitioner | 300-a Forest Avenue, Paramus, NJ 07652 | 2020-09-15 |
| 1740801679 | Daniel Khodorkovsky | Dentist | 1615 Paramus Park, Paramus, NJ 07652 | 2020-05-01 |
| 1548806177 | Shira R Goldstein | Social Worker | 10 Valley Health Plaza, Paramus, NJ 07652 | 2019-11-19 |
| 1225598634 | Life Opportunities Unlimited A Non-profit Corp. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 157 Windsor Rd, Paramus, NJ 07652 | 2019-03-21 |
| 1639635766 | Inna Revutsky | Acupuncturist | Applied Kinesiology Center of Nj, 1 Sears Drive Suite 203, Paramus, NJ 07652 | 2019-02-13 |
| 1154899532 | Aleksandra Bozovic | Nurse Practitioner | 970 Linwood Avenue, Suite 102, Paramus, NJ 07652 | 2018-11-05 |
| 1689156044 | Christopher John Kailath | Behavioral Analyst | 10 Forest Ave Suite 214, Paramus, NJ 07652 | 2018-09-02 |
| 1841786696 | Molly Katherine Lenny | Optometrist | 501 Route 17 South, Paramus, NJ 07652 | 2018-07-05 |
| 1508356155 | Physical Therapy Now Holdings Nj LLC | Clinic/Center | 695 Route 17 South, Paramus, NJ 07652 | 2018-05-18 |
| 1821514373 | Simona Dlabal | Nurse Practitioner | 69 Prospect St, Paramus, NJ 07652 | 2017-08-16 |
| Find all providers in zip 07652 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588070874 | Roel P Galope Do | Specialist | 186 N Farview Ave, Paramus, NJ 07652-3235 | 2014-07-07 |
| 1821350133 | Maria Elizabeth Salyer | Specialist | 519 Green Valley Rd, Paramus, NJ 07652-1810 | 2012-06-12 |
| 1417090697 | Tom R Willemann | Specialist | 1 E Ridgewood Ave, Paramus, NJ 07652-3629 | 2007-02-15 |
| 1669511036 | Syed A Rasheed | Specialist | 12 N State Rt 17, Suite 313, Paramus, NJ 07652-2644 | 2007-02-05 |
| 1093864563 | Solomon Halioua | Specialist | 22 Madison Ave Ste 201, Paramus, NJ 07652-2721 | 2007-01-10 |
| 1386701282 | Amit Trivedi | Specialist | 81 Rte. 4 W., 35 Plaza Professional Center, Suite 401, Paramus, NJ 07652-0058 | 2007-01-02 |
| 1841353737 | Advanced Laparoscopic Associates | Specialist | 81rte. 4w., 35 Plaza Professional Center, Suite 401, Paramus, NJ 07652-0058 | 2006-12-19 |
| 1851405781 | Spine & Sports Rehab Ctr | Specialist | 205 Robin Rd Ste 118, Paramus, NJ 07652-1424 | 2006-08-18 |
| 1134113582 | Heripsime Ohanian | Specialist | 1 Kalisa Way, Suite 103, Paramus, NJ 07652-3516 | 2005-08-31 |
| 1851399588 | Justito Malazarte | Specialist | 230 E Ridgewood Ave, Paramus, NJ 07652-4142 | 2005-07-07 |
| Find all providers in PARAMUS | ||||
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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.