MICHAEL WIEDERKEHR (NPI# 1396759783) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396759783 |
| Entity Type | Individual |
| Full Name | MICHAEL WIEDERKEHR |
| Credential | MD |
| Practice Address |
1 W Ridgewood Ave Suite 103 Paramus NJ 07652-2359 |
| Practice Telephone | 2018574200 |
| Practice Fax Number | 2018574199 |
| Mailing Telephone | 2018574200 |
| Mailing Fax Number | 2018574199 |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2017-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | MA069839 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEA | BW7734521 | 01 | |
| CDS | D081378 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932153681 | Michael Wiederkehr | Internal Medicine | 411 N Washington Ave, Suite 7000, Dallas, TX 75246-1713 | 2006-05-19 |
| Street Address |
1 W RIDGEWOOD AVE SUITE 103 |
| City | PARAMUS |
| State | NJ |
| Zip Code | 07652-2359 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417953902 | Rajnik W Raab | Neurological Surgery | 1 W Ridgewood Ave, Ste 208, Paramus, NJ 07652-2350 | 2005-06-21 |
| 1992217616 | Pathik Tuhin Suvarnakar | Pharmacist | 1 W Ridgewood Ave, Paramus, NJ 07652-2359 | 2017-11-03 |
| 1891243606 | Hemin Vaidya | Pharmacist | 1 W Ridgewood Ave, Paramus, NJ 07652-2359 | 2016-09-21 |
| 1215383443 | Alison Elizabeth Cooper | Nurse Practitioner | 1 W Ridgewood Ave, Suite 106, Paramus, NJ 07652 | 2016-05-06 |
| 1952769960 | Geriatrics and Internal Medicine Associates of Northeast LLC | Internal Medicine | 1 W Ridgewood Ave, Suite 203, Paramus, NJ 07652-2359 | 2016-02-04 |
| 1588034078 | Cityscape Anesthesia Pllc | Anesthesiology | 1 W Ridgewood Ave, Suite G03, Paramus, NJ 07652-2359 | 2015-09-28 |
| 1194121814 | Kyle Christopher D'amico | Physical Medicine & Rehabilitation | 1 W Ridgewood Ave, Paramus, NJ 07652-2359 | 2014-11-06 |
| 1659799328 | Bergen Gastroenterology PC | Non-Pharmacy Dispensing Site | 1 W Ridgewood Ave, Suite 301, Paramus, NJ 07652-2359 | 2014-03-31 |
| 1508298241 | Alpha Diagnostic of New Jersey LLC | Radiology | 1 W Ridgewood Ave, Suite G01-g02, Paramus, NJ 07652-2359 | 2013-08-05 |
| 1194061168 | Rakesh Patel Md PC | Specialist | 1 W Ridgewood Ave, Suite 106, Paramus, NJ 07652-2359 | 2012-12-19 |
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| 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 | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982986634 | Sunny Kyung Chun | Dermatology | 4 Forest Ave Ste 205, Paramus, NJ 07652-5214 | 2011-09-19 |
| 1639105331 | Carmen J Garcia | Dermatology | 326 Franklin Pl, Paramus, NJ 07652-4912 | 2006-06-24 |
| 1417919051 | Saida Baxt | Dermatology | 351 Evelyn St, Paramus, NJ 07652 | 2006-04-06 |
| 1043735343 | Sunterprise Health LLC | Dermatology | 4 Forest Ave Ste 205, Paramus, NJ 07652-5214 | 2017-08-08 |
| 1194051243 | Center for Dermatology and Skin Surgery LLC | Dermatology | 1 W Ridgewood Ave, Suite 103, Paramus, NJ 07652-2359 | 2009-10-26 |
| 1659539443 | Alexis Livingston Young | Dermatology | 277 Forest Avenue, Suite 207, Paramus, NJ 07652 | 2008-05-28 |
| 1891837209 | Saidabaxtmdpa | Dermatology | 351 Evelyn St, 2nd Floor, Paramus, NJ 07652-2901 | 2007-02-13 |
| 1417913245 | Rebecca D Baxt | Dermatology | 351 Evelyn St, Paramus, NJ 07652 | 2006-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326649716 | Danowski Dermatology | Dermatology | 525 Route 73 N Ste 305a, Marlton, NJ 08053-3422 | 2020-11-03 |
| 1508477399 | Consonant Healing Medical Associates of Nj LLC | Dermatology | 100 Challenger Rd # 205, Ridgefield Park, NJ 07660-2108 | 2020-08-13 |
| 1659900884 | Dermatology and Skin Care Center | Dermatology | 2301 E Evesham Rd Ste 102-103, Voorhees, NJ 08043-4501 | 2020-04-08 |
| 1467091983 | Aura Dermatology At Somerset LLC | Dermatology | 75 Veronica Ave Ste 205, Somerset, NJ 08873-5002 | 2020-01-01 |
| 1578025920 | Aura Dermatology At Robbinsville LLC | Dermatology | 17 Main St Ste 304, Robbinsville, NJ 08691-1436 | 2019-04-04 |
| 1144786740 | Swetha Kandula Md LLC | Dermatology | 3695 Hill Rd Ste 2b, Parsippany, NJ 07054-1047 | 2019-02-19 |
| 1477031318 | Wellness Dermatology LLC | Dermatology | 638 Lawrenceville Rd, Lawrenceville, NJ 08648-4208 | 2018-08-02 |
| 1871000323 | Julianna Nicole Jarvis | Dermatology | 100 Brick Rd Ste 306, Marlton, NJ 08053-2146 | 2018-01-05 |
| 1487169702 | Nj Certified Dermatology PC | Dermatology | 670 Broadway, Bayonne, NJ 07002-4726 | 2017-12-08 |
| 1407374796 | Geria Dermatology, LLC | Dermatology | 75 Orient Way Ste 204, Rutherford, NJ 07070-2086 | 2017-09-06 |
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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.