PEDIATRIC INTENSIVE CARE ASSOCIATES, LLC (NPI# 1346458007) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346458007 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC INTENSIVE CARE ASSOCIATES, LLC |
| Practice Address |
30 Prospect Ave Hackensack NJ 07601-1914 |
| Mailing Address |
58 Lee Rd Livingston NJ 07039-4134 |
| Practice Telephone | 2019965303 |
| Practice Fax Number | 2019960754 |
| Mailing Telephone | 2019965303 |
| Mailing Fax Number | 2019960754 |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. BRUCE FRIEDMAN (PRESIDENT) |
| Authorized Official Telephone | 2019965303 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
30 PROSPECT AVE |
| City | HACKENSACK |
| State | NJ |
| Zip Code | 07601-1914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417955279 | Despee Bockarie Konneh | Physician Assistant | 30 Prospect Ave, Hackensack, NJ 07601-1915 | 2005-07-14 |
| 1629675616 | Jena Marie Ahmed | Nurse Practitioner | 30 Prospect Ave, Hackensack, NJ 07601-1915 | 2020-10-03 |
| 1114532173 | Caroline Castro | Nurse Practitioner | 30 Prospect Ave, Hackensack, NJ 07601-1915 | 2020-09-15 |
| 1013521244 | Stephanie Akanbi | Nurse Practitioner | 30 Prospect Ave, Hackensack, NJ 07601-1915 | 2020-09-04 |
| 1639781388 | Caitlin Brianna Powers | Registered Nurse | 30 Prospect Ave, Hackensack, NJ 07601-1915 | 2020-08-22 |
| 1457960270 | Neha Bhasin | Registered Nurse | 30 Prospect Ave, Hackensack, NJ 07601-1915 | 2020-07-28 |
| 1083232375 | James Robert Hoff IIi | Physician Assistant | 30 Prospect Ave, Hackensack, NJ 07601-1915 | 2020-07-13 |
| 1043834336 | Daniel Sheldon | Physician Assistant | 30 Prospect Ave, Hackensack, NJ 07601-1915 | 2020-06-02 |
| 1710500780 | Ferdinand Pontejos | Nurse Practitioner | 30 Prospect Ave, Hackensack, NJ 07601-1915 | 2020-05-25 |
| 1972126969 | Eric Hugenberg | Pharmacist | 30 Prospect Ave, Hackensack, NJ 07601-1915 | 2020-05-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750989414 | Alpha Healthcare Staffing Firm, LLC | Registered Nurse | 194 Passaic Street, Hackensack, NJ 07601 | 2020-10-15 |
| 1396350120 | Lower Limb Institute | Podiatrist | 211 Esses Street, Suite 405, Hackesack, NJ 07601 | 2020-09-09 |
| 1649825233 | Rachel Korenblit | Social Worker | 235 Main St Ste 203, Hackensack, NJ 07601 | 2019-08-09 |
| 1740846567 | Samantha Pirnat | Counselor | 426 Hudson Street, 2nd Floor, Hackensack, NJ 07601 | 2019-05-16 |
| 1881258499 | Tara Lynn Smith | Social Worker | 160 South River Street, Hackensack, NJ 07601 | 2019-04-29 |
| 1922569318 | Solomon Isakov | Dentist | 835 Prospect Ave, Suite 304, Hackensack, NJ 07601 | 2019-03-27 |
| 1114403409 | Mildred Lopez Vasquez | Home Health Aide | 12 Rowland Avenue, Hackensack, NJ 07601 | 2018-07-19 |
| 1538656582 | Zara Pharmacy LLC | Pharmacy | 57 Linden St, Hackensack, NJ 07601 | 2018-04-16 |
| 1447759048 | Maryann Hom | Social Worker | 307 Prospect Avenue, 14e, Hackensack, NJ 07601 | 2018-02-08 |
| 1699274258 | Kirsten Byrnes | Psychologist | Audrey Hepburn Children's House, Hackensack Umc, 12 Second St, Hackensack, NJ 07601 | 2018-02-08 |
| Find all providers in zip 07601 | ||||
| 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 |
|---|---|---|---|---|
| 1376956946 | Rachel Lewis | Pediatrics | 30 Prospect Ave, Picu, Hackensack, NJ 07601-1915 | 2014-06-11 |
| 1528326980 | Amy L. Chirico | Pediatrics | 30 Prospect Ave, Hackensack, NJ 07601 | 2012-04-24 |
| 1457480113 | Bruce Ira Friedman | Pediatrics | 30 Prospect Ave, Hackensack, NJ 07601-1914 | 2007-03-05 |
| 1841366374 | Pediatric Intensive Care Associates, P.C. | Pediatrics | 30 Prospect Ave, Hackensack, NJ 07601-1914 | 2006-11-27 |
| 1063586485 | Stephen Percy Jr. | Pediatrics | 30 Prospect Ave, Hackensack University Medical Center, Hackensack, NJ 07601-1914 | 2006-11-17 |
| 1053494021 | Mark Eric Siegel | Pediatrics | 30 Prospect Ave, Imus Bldg, 3rd Fl, Hackensack Univ. Medical Center, Hackensack, NJ 07601-1914 | 2006-10-23 |
| 1740237759 | Shira Jolene Gertz | Pediatrics | 30 Prospect Ave, Suite 900, Hackensack, NJ 07601-1914 | 2006-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821174558 | Meena Kalyanaraman | Pediatrics | 201 Lyons Ave # C-5, Newark, NJ 07112-2027 | 2006-10-27 |
| 1568705051 | Maria Luisa Escobar | Pediatrics | 100 Madison Ave, Morristown, NJ 07960-6136 | 2013-04-03 |
| 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 |
| 1043449671 | Mario Charles Colletti | Pediatrics | 703 Main St, Paterson, NJ 07503 | 2009-07-02 |
| 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 |
| 1083876106 | Hariprem Rajasekhar | Pediatrics | 1 Robert Wood Johnson Pl, Meb 3rd Floor, New Brunswick, NJ 08901-1928 | 2008-06-30 |
| Find all providers with the same taxonomy | ||||
| City | HACKENSACK |
| Zip Code | 07601 |
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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.