MARY T. MITSKAVICH (NPI# 1457355117) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457355117 |
| Entity Type | Individual |
| Full Name | MARY T. MITSKAVICH |
| Credential | M.D. |
| Practice Address |
3700 Route 33 Suite 101 Neptune NJ 07753 |
| Practice Telephone | 7322807855 |
| Practice Fax Number | 7322807815 |
| Mailing Telephone | 7322807855 |
| Mailing Fax Number | 7322807815 |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2012-01-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | MA63523 | NJ | Allopathic & Osteopathic Physicians |
| Street Address |
3700 ROUTE 33 SUITE 101 |
| City | NEPTUNE |
| State | NJ |
| Zip Code | 07753 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154943421 | Brooke Mason | Physician Assistant | 3700 Route 33, Ste101, Neptune, NJ 07753 | 2020-05-10 |
| 1285195842 | Courtney Casler Cieri | Audiologist | 3700 Route 33, Suite 101, Neptune, NJ 07753 | 2019-03-27 |
| 1982123469 | Bijal Parmar | Physician Assistant | 3700 Route 33, Neptune, NJ 07753-3268 | 2017-09-15 |
| 1902224942 | Pratik Bharat Patel | Otolaryngology | 3700 Route 33, Suite 101, Neptune, NJ 07753 | 2014-04-05 |
| 1801141023 | Narine Azoyan | Nurse Practitioner | 3700 Route 33, Suite 101, Neptune, NJ 07753-3206 | 2012-07-14 |
| 1891058665 | Caitlin Yesis | Audiologist | 3700 Route 33, Ste 101, Neptune, NJ 07753-3269 | 2012-06-18 |
| 1316219470 | Coastal Surgery Center, LLC | Clinic/Center | 3700 Route 33, Suite Ll-01, Neptune, NJ 07753-3206 | 2012-02-06 |
| 1699088724 | Kristen Campbell | Audiologist | 3700 Route 33, Suite 101, Neptune, NJ 07753-3268 | 2010-07-18 |
| 1619102662 | Mohammad Usman Nasir Khan | Surgery | 3700 Route 33, Suite C 2nd Floor, Neptune, NJ 07753-3206 | 2009-05-20 |
| 1437393063 | Habib Khan | Surgery | 3700 Route 33, 2nd Floor-suite C, Neptune, NJ 07753-3268 | 2009-04-27 |
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| 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 |
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| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902224942 | Pratik Bharat Patel | Otolaryngology | 3700 Route 33, Suite 101, Neptune, NJ 07753 | 2014-04-05 |
| 1083820518 | Samuel H Engel | Otolaryngology | 3700 Route 33, Suite 101, Neptune, NJ 07753-3206 | 2007-05-14 |
| 1598769259 | Sean D. Houston | Otolaryngology | 3700 Route 33, Suite 101, Neptune, NJ 07753 | 2005-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962977249 | Clinical Health Care Associates of New Jersey, PC | Otolaryngology | 719 Us Highway 206 Ste 101, Hillsborough, NJ 08844-1529 | 2018-10-12 |
| 1962918078 | Ira Sanders | Otolaryngology | 5 Rye Cliff Rd, Oakland, NJ 07436-1423 | 2017-12-27 |
| 1053772608 | St. Luke's Warren Physician Group, PC | Otolaryngology | 755 Memorial Pkwy Ste 112, Phillipsburg, NJ 08865-2774 | 2016-03-10 |
| 1023484052 | Eun Hae Chang | Otolaryngology | 1131 Broad St Ste 102, Shrewsbury, NJ 07702-4334 | 2015-08-13 |
| 1184010415 | Alisa Yamasaki | Otolaryngology | 1543 State Route 27 Ste 21, Somerset, NJ 08873-4015 | 2015-04-14 |
| 1134532708 | Ahmad F Mahmoud | Otolaryngology | 6 Brighton Rd Ste 104, Clifton, NJ 07012-1647 | 2014-06-11 |
| 1881007250 | David A Temmermand | Otolaryngology | 620 North Broad Street, Woodbury, NJ 08096 | 2014-06-03 |
| 1477986420 | Amit N Bhojwani | Otolaryngology | 708 Gregorys Way, Voorhees, NJ 08043-2055 | 2013-08-14 |
| 1831440726 | Anthony G Rossi | Otolaryngology | 912 Pompton Ave, Suite A1, Cedar Grove, NJ 07009-1264 | 2012-10-02 |
| 1871802751 | Ronald B Lorenc Md Pa | Otolaryngology | 225 Laurel Heights Dr, Bridgeton, NJ 08302-3635 | 2010-09-27 |
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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.