STATIONMD PROFESSIONAL CORPORATION (NPI# 1285015347) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285015347 |
| Entity Type | Organization |
| Organization Name | STATIONMD PROFESSIONAL CORPORATION |
| Practice Address |
515 Valley St Ste 203 Maplewood NJ 07040-4300 |
| Practice Telephone | 9086632929 |
| Practice Fax Number | 9086632913 |
| Mailing Telephone | 9086632929 |
| Mailing Fax Number | 9086632913 |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2020-06-08 |
| Authorized Official Name | DR. DEVEN UNADKAT (CHIEF MEDICAL OFFICER) |
| Authorized Official Telephone | 9086632929 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 50 W Broad St Ste 1330, Columbus, OH 432153307 | 2019213951 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | STATIONMD PROFESSIONAL CORPORATION | 80 State Street, Albany, Ny 122072543 |
| Street Address |
515 VALLEY ST STE 203 |
| City | MAPLEWOOD |
| State | NJ |
| Zip Code | 07040-4300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487896148 | Matthew Lobosco | Psychiatry & Neurology | 515 Valley St Ste 203, Maplewood, NJ 07040-4300 | 2009-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538654462 | Ajibola G Alli | Counselor | 15 Hausmann Ct Fl 1, Maplewood, NJ 07040 | 2018-06-23 |
| 1487142980 | Monica Goodrich | Student in an Organized Health Care Education/Training Program | Winchester Gardens, 333 Elmwood Ave, Maplewood, NJ 07040 | 2018-04-30 |
| 1487173795 | Jessica M Hodge | Marriage & Family Therapist | 35 Marie Place, Maplewood, NJ 07040 | 2017-09-18 |
| 1386173797 | Marianne Nadine Rubino | Social Worker | 111 Dunnell Road, Suite 201-8, Maplewood, NJ 07040 | 2017-06-08 |
| 1629504881 | Krishna Surapaneni | Pharmacist | 747 Irvington Avenue, Maplewood, NJ 07040 | 2017-05-10 |
| 1548717143 | Mindset Psychotherapy Center | Social Worker | 2040 Millburn Ave. Suite 205, Maplewood, NJ 07040 | 2016-09-01 |
| 1588010888 | Rochelle Laverne Brunson | Massage Therapist | 2130 Millburn Ave., Suite C8, Maplewood, NJ 07040 | 2016-05-05 |
| 1881082774 | Perry Grossman | Physical Medicine & Rehabilitation | 137 Parker Avenue, Maplewood, NJ 07040 | 2014-12-31 |
| 1124436746 | Karen Reckson | Specialist | 24 Beach Place, Maplewood, NJ 07040 | 2014-07-28 |
| 1427462670 | Appetite for Health | Dietitian, Registered | 94 Claremont Ave, Maplewood, NJ 07040 | 2014-06-16 |
| Find all providers in zip 07040 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932549474 | Wendy M Chan | Emergency Medicine | 13 Oakland Rd, Maplewood, NJ 07040-2224 | 2013-06-28 |
| 1457647497 | Andrew Bernard Theilen | Emergency Medicine | 2711 Laclede Station Rd Apt C, Maplewood, MO 63143-2825 | 2011-06-28 |
| 1730137829 | Kai Adam Tuominen | Emergency Medicine | 1655 Beam Avenue, Suite 302 Maplewood Prof Bldg, Maplewood, MN 55109-1126 | 2006-05-04 |
| 1568970051 | Rachel Holen | Emergency Medicine | 1575 Beam Ave, Maplewood, MN 55109-1126 | 2018-01-18 |
| 1508395708 | Amy Rachel Borys | Emergency Medicine | 1575 Beam Ave, Maplewood, MN 55109-1126 | 2017-06-09 |
| 1366971988 | Mary Rochelle Swiggum | Emergency Medicine | 1575 Beam Ave, Maplewood, MN 55109-1126 | 2017-06-07 |
| 1780035279 | Oliver Garrison | Emergency Medicine | 1575 Beam Ave, Maplewood, MN 55109-1126 | 2016-06-26 |
| 1699137216 | Jeffrey Michael Corajod | Emergency Medicine | 1575 Beam Ave, Maplewood, MN 55109-1126 | 2016-03-23 |
| 1215323787 | Michael H Bambenek | Emergency Medicine | 1575 Beam Ave, Maplewood, MN 55109-1126 | 2015-04-12 |
| 1811302201 | Elise Heeringa Hart | Emergency Medicine | 1575 Beam Ave, Maplewood, MN 55109-1126 | 2014-06-25 |
| Find all providers in MAPLEWOOD | ||||
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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.