MR. MATTHEW J PETRIDES (NPI# 1407827496) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407827496 |
| Entity Type | Individual |
| Full Name | MR. MATTHEW J PETRIDES |
| Credential | PA-C |
| Practice Address |
1945 Corlies Ave Neptune City NJ 07753-4859 |
| Mailing Address |
1945 State Route 33 Neptune NJ 07753-4859 |
| Practice Telephone | 7327755500 |
| Mailing Telephone | 7327764618 |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2010-11-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
25MP00032400 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1945 CORLIES AVE |
| City | NEPTUNE CITY |
| State | NJ |
| Zip Code | 07753-4859 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043754138 | Ashley Coville | Nurse Practitioner | 1945 Corlies Ave, Neptune City, NJ 07753-4859 | 2016-12-08 |
| 1649621830 | Alyssa M Erb | Student in an Organized Health Care Education/Training Program | 1945 Corlies Ave, Department of Ob/gyn, Neptune City, NJ 07753-4859 | 2016-06-29 |
| 1881909323 | Jersey Shore Medical Center | General Acute Care Hospital | 1945 Corlies Ave, Route 33, Neptune City, NJ 07753-4859 | 2010-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255938361 | Maryjoy Marzan | Nurse Practitioner | Hope Tower - Jersey Shore University Medical Center, 19 Davis St 6th Floor, Neptune, NJ 07753 | 2020-10-02 |
| 1174138952 | Darlene Lupo | Nurse Practitioner | 72 Morris Ave, Neptune, NJ 07753 | 2020-09-09 |
| 1124645148 | Charlotte Emily Parker | Audiologist | 3700 Nj-33, Suite 101, Neptune City, NJ 07753 | 2020-06-26 |
| 1023667896 | Joseph Renninger | Psychologist | 2100 Route 33 Suite 9/10, Neptune, NJ 07753 | 2019-09-05 |
| 1952950800 | Matthew Aaron Brigle | Psychologist | 2100 Nj-33, Suite 9-10, Neptune City, NJ 07753 | 2019-09-04 |
| 1285292110 | Joseph F Mcnamara | Nurse Practitioner | 1945 Nj State Highway 33, Neptune, NJ 07753 | 2019-06-05 |
| 1679046601 | Richard Valderas Penalosa Jr. | Nurse Practitioner | 409 Locust St, Neptune, NJ 07753 | 2019-01-02 |
| 1528539822 | Neptune Rx LLC | Pharmacy | West Lake Pharmacy, 1828 West Lake Avenue, Neptune, NJ 07753 | 2018-12-12 |
| 1053880286 | Hmh Hospitals Corporation | Clinic/Center | 1200 Jumping Brook Rd., Bldg 5, Ste 201, Neptune, NJ 07753 | 2018-11-16 |
| 1972084424 | Melissa Hillebrecht | Psychologist | 2100 Nj-33 Suite 9-10, Neptune, NJ 07753 | 2018-08-23 |
| Find all providers in zip 07753 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164830352 | Yohana Sanchez | Physician Assistant | 115 Hawthorne Ave, Neptune City, NJ 07753-6337 | 2014-07-31 |
| 1386042042 | Cheresse Malagad | Physician Assistant | 1945 Route 33, Neptune City, NJ 07753-4859 | 2014-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062463 | Erica Josephine Lobuglio | Physician Assistant | 733 N Beers St Ste U3, Holmdel, NJ 07733-1513 | 2020-08-04 |
| 1407471493 | Angelice Grasso | Physician Assistant | 3 Holly Ln, Garfield, NJ 07026-3565 | 2020-06-15 |
| 1063036358 | Jaina Marie Lumkong | Physician Assistant | 905 Allwood Rd Ste 204, Clifton, NJ 07012-1946 | 2020-06-02 |
| 1740804384 | Allison Sy Tan | Physician Assistant | 10 Bahr Cir, Verona, NJ 07044-3200 | 2020-05-29 |
| 1114560851 | Brian Paul Leonhardt | Physician Assistant | 1113 Hospital Drive Professional Building East, Suite 100, Willingboro, NJ 08046 | 2019-10-25 |
| 1740830413 | Atara Hagler | Physician Assistant | 1500 Pleasant Valley Way Ste 101, West Orange, NJ 07052-2956 | 2019-09-16 |
| 1568943058 | Ekaterina M Rezvin | Physician Assistant | 80 Woodland Park Dr, Tenafly, NJ 07670-3028 | 2018-08-23 |
| 1225550353 | Kristen Cordiello | Physician Assistant | 1610 Route 88 Ste 203, Brick, NJ 08724-3018 | 2017-07-11 |
| 1710408232 | Angela Marie Freedman | Physician Assistant | 1 Riverview Plaza Multi Disciplinary Cancer Center, Red Bank, NJ 07701 | 2017-07-06 |
| 1063932259 | Matthew Gabriel | Physician Assistant | 25 Prospect Avernue, 2nd Floor, Hackensack, NJ 07601 | 2017-06-20 |
| Find all providers with the same taxonomy | ||||
| City | NEPTUNE CITY |
| Zip Code | 07753 |
Please comment or provide details below to improve the information on MR. MATTHEW J PETRIDES.
| 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.