BRIAN JOSEPH PORTANOVA (NPI# 1336595800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336595800 |
| Entity Type | Individual |
| Full Name | BRIAN JOSEPH PORTANOVA |
| Credential | FNP-BC |
| Practice Address |
45 Euclid St Ste 200 Woodbury NJ 08096-4631 |
| Practice Telephone | 8566284504 |
| Mailing Telephone | 8566284504 |
| Enumeration Date | 2016-05-13 |
| Last Update Date | 2020-07-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
SP015756 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
26NJ00628000 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 175 Madison Ave Fl 4, Mount Holly, NJ 080602038 | 6097021900 | 6097028456 |
| Street Address |
45 EUCLID ST STE 200 |
| City | WOODBURY |
| State | NJ |
| Zip Code | 08096-4631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780226043 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1460 Cooper Street, Deptford, NJ 08096 | 2019-10-08 |
| 1730652058 | Robert Crawford Counseling & Consultation, LLC | Counselor | Robert Crawford Counseling & Consultation, LLC, 44 Cooper Street, Suite 208, Woodbury, NJ 08096 | 2019-01-09 |
| 1902381171 | Services To Overcome Drug Abuse Among Teenagers, Inc. | Clinic/Center | 124 N Broad Street, Woodbury, NJ 08096 | 2018-10-03 |
| 1225518715 | Michael West | Pharmacist | 631 West Mantua Ave, Woodbury, NJ 08096 | 2018-08-15 |
| 1053807891 | Standing Ground Counseling, LLC | Clinic/Center | 44 Cooper Street, Suite 104, Woodbury, NJ 08096 | 2018-07-05 |
| 1376054536 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 40 Hessian Avenue, Woodbury, NJ 08096 | 2017-10-16 |
| 1881105021 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1154 Bennett Drive, Deptford, NJ 08096 | 2017-10-16 |
| 1215448469 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7 North Evergreen Avenue, Woodbury, NJ 08096 | 2017-10-16 |
| 1801307137 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6 North Drexel Street, Woodbury, NJ 08096 | 2017-10-13 |
| 1295253847 | Sara Alven | Social Worker | 1 Lupton Avenue, Woodbury, NJ 08096 | 2017-09-05 |
| Find all providers in zip 08096 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851913255 | Shrena H Travis | Nurse Practitioner | 126 Lester St, Woodbury, TN 37190-1416 | 2020-05-08 |
| 1407401466 | Linda Lor | Nurse Practitioner | 1795 Radio Dr Ste D, Woodbury, MN 55125-9457 | 2019-08-07 |
| 1518429273 | Jennifer L Ergang | Nurse Practitioner | 3405 Hartford Rd, Woodbury, MN 55125-3734 | 2019-04-02 |
| 1629536651 | Shamim A Lalani | Nurse Practitioner | 9 Sparrow Ln, Woodbury, NY 11797-3206 | 2019-03-08 |
| 1184070591 | Grace Oghenekaro Oyefesobi | Nurse Practitioner | 8468 Tamarack Village, Cvs Minute Clinic, Woodbury, MN 55125 | 2016-05-04 |
| 1770844110 | Community Wellness Clinic Inc. | Nurse Practitioner | 322 S Mccrary St, Woodbury, TN 37190-1441 | 2012-06-01 |
| 1003112277 | Tabitha M Smith | Nurse Practitioner | 89 Mears Drive, Woodbury, TN 37190-1441 | 2011-02-04 |
| 1023240041 | Heidi Lee Brown | Nurse Practitioner | 7650 Currell Blvd Ste 330, Woodbury, MN 55125-8209 | 2009-08-11 |
| 1144273061 | Paula Todd | Nurse Practitioner | 530 W Adams St, Woodbury, TN 37190-1622 | 2006-05-19 |
| 1790746808 | Karen Ann Zimmerman | Nurse Practitioner | 1825 Woodwinds Drive, Woodbury, MN 55125-2298 | 2006-03-29 |
| Find all providers in WOODBURY | ||||
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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.