DAVID EVDOKIMOW, M.D. LLC (NPI# 1124466966) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124466966 |
| Entity Type | Organization |
| Organization Name | DAVID EVDOKIMOW, M.D. LLC |
| Practice Address |
96 South Finley Ave. Basking Ridge NJ 07920 |
| Practice Telephone | 9082210482 |
| Practice Fax Number | 9082210482 |
| Mailing Telephone | 9082210482 |
| Mailing Fax Number | 9082210482 |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2013-06-13 |
| Authorized Official Name | DAVID Z EVDOKIMOW (PRESIDENT) |
| Authorized Official Telephone | 9082211136 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ND0900X |
Dermatology Specialization: Dermatopathology |
Allopathic & Osteopathic Physicians | ||
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 2086S0105X |
Surgery Specialization: Surgery of the Hand |
Allopathic & Osteopathic Physicians | ||
| N | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
Allopathic & Osteopathic Physicians |
| Street Address |
96 SOUTH FINLEY AVE. |
| City | BASKING RIDGE |
| State | NJ |
| Zip Code | 07920 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073128450 | Margo Lee Tarasov | Social Worker | Rr 22 West, Bridgewater, NJ 07920 | 2020-09-11 |
| 1053894196 | Riverwalk Pharmacy LLC | Pharmacy | 665 Marinsville Rd Unite 9b, Basking Ridge, NJ 07920 | 2018-09-14 |
| 1164967196 | Somerset County Ymca | Community/Behavioral Health | 140 Mt. Airy Road, Basking Ridge, NJ 07920 | 2016-12-29 |
| 1649627159 | Dungarvin New Jersey, LLC-woodward | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 139 Woodward Ln, Basking Ridge, NJ 07920 | 2016-05-16 |
| 1134597115 | Sarah Kane | Genetic Counselor, MS | 136 Mountainview Blvd., Basking Ridge, NJ 07920 | 2015-09-09 |
| 1497137087 | Matheny School and School | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 33 North Maple Avenue, Basking Ridge Community Residence, Basking Ridge, NJ 07920 | 2015-06-19 |
| 1497194203 | Lauren Elizabeth Grabiec | Nurse Practitioner | 140 Allen Rd., Basking Ridge, NJ 07920 | 2013-06-14 |
| 1720425804 | Carol J Skolnik | Occupational Therapist | 101 Peachtree Rd, Basking Ridge, NJ 07920 | 2013-05-29 |
| 1871863027 | Heather Lonergan | Counselor | 233 Mt.airy Rd, Basking Ridge, NJ 07920 | 2012-01-05 |
| 1447538616 | Janice P Milstein | Behavioral Analyst | 36 Hickory Drive, Basking Ridge, NJ 07920 | 2011-07-22 |
| Find all providers in zip 07920 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356805402 | Sr Plastic Surgery PC | Surgery | 2 Cornwall Dr, Unit B2, East Brunswick, NJ 08816 | 2019-01-23 |
| 1639655871 | Center for Plastic Cosmetic and Hand Surgery PC | Surgery | 127 Church Rd Ste 100, Marlton, NJ 08053-9402 | 2018-07-11 |
| 1265745111 | Jain Joseph | Surgery | 1 Diamond Hill Rd Fl 1, Berkeley Heights, NJ 07922 | 2010-07-21 |
| 1669631362 | Atlantic Plastic and Hand Surgery, Pa | Surgery | 2 Route 27, Suite 508, Edison, NJ 08820-3961 | 2008-06-06 |
| 1588877823 | Metamorphosis Plastic Surgery | Surgery | 42 Brook Drive South, New Vernon, NJ 07976 | 2007-05-07 |
| 1790824589 | Michael Rosen Md PC | Surgery | 1114 Hooper Ave, Toms River, NJ 08753-8325 | 2007-02-06 |
| 1447319777 | Paul H Rosenberg | Surgery | 1567 Palisade Ave 3rd Floor, Fort Lee, NJ 07024-6923 | 2006-12-06 |
| 1982783890 | John Mesa | Surgery | 200 S Orange Ave Ste 255, Livingston, NJ 07039 | 2006-11-02 |
| 1538264676 | Jamsheed Khodadad Najmi | Surgery | 8 Woodstock Ln, Annandale, NJ 08801-3425 | 2006-09-13 |
| 1790893998 | Paul Joseph Vallone | Surgery | 369 West Blackwell St, Dover, NJ 07801-2545 | 2006-08-28 |
| Find all providers with the same taxonomy | ||||
| City | BASKING RIDGE |
| Zip Code | 07920 |
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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.