PEDERSEN FAMILY MEDICINE, LLC (NPI# 1497123418) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497123418 |
| Entity Type | Organization |
| Organization Name | PEDERSEN FAMILY MEDICINE, LLC |
| Practice Address |
1450 E Chestnut Ave Building 3, Suite D Vineland NJ 08361-8467 |
| Mailing Address |
2743 Bethpage Ct Vineland NJ 08361-7741 |
| Practice Telephone | 8566920050 |
| Practice Fax Number | 8566920081 |
| Mailing Telephone | 8566305506 |
| Enumeration Date | 2015-09-08 |
| Last Update Date | 2015-09-08 |
| Authorized Official Name | DR. DANIEL A PEDERSEN (SOLE MEMBER) |
| Authorized Official Telephone | 8566305506 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 25MB09405100 | NJ | Allopathic & Osteopathic Physicians |
| Street Address |
1450 E CHESTNUT AVE BUILDING 3, SUITE D |
| City | VINELAND |
| State | NJ |
| Zip Code | 08361-8467 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871574962 | David Galetto | Internal Medicine | 1450 E Chestnut Ave, Bldg 3 Suite A, Vineland, NJ 08361-8467 | 2005-11-07 |
| 1740667013 | Singleton Dental, LLC | Dentist | 1450 E Chestnut Ave, #3-c, Vineland, NJ 08361-8467 | 2015-05-06 |
| 1821494501 | 1450 Associates, LLC | Durable Medical Equipment & Medical Supplies | 1450 E Chestnut Ave, Bldg 4, Vineland, NJ 08361-8467 | 2014-11-07 |
| 1336554278 | Cumberland Internal Medicine Pa | Non-Pharmacy Dispensing Site | 1450 E Chestnut Ave, Building 3a, Vineland, NJ 08361-8467 | 2014-06-30 |
| 1912166133 | Russell Paige Singleton | Dentist | 1450 E Chestnut Ave, #3-c, Vineland, NJ 08361-8467 | 2008-06-03 |
| 1932376621 | 1450 Associates LLC | Clinic/Center | 1450 E Chestnut Ave, Building 4 Suite A, Vineland, NJ 08361-8467 | 2008-05-12 |
| 1922274158 | Sleepcare Centers, Inc | Specialist | 1450 E Chestnut Ave, Bldg. 6 Ste.b, Vineland, NJ 08361-8467 | 2008-05-07 |
| 1821276015 | Vakula Devi Atthota | Internal Medicine | 1450 E Chestnut Ave, Bldg 3 Suite A, Vineland, NJ 08361-8467 | 2008-02-10 |
| 1376685875 | Melody A Shepherd-thomas | Internal Medicine | 1450 E Chestnut Ave, Bldg 3 Suite A, Vineland, NJ 08361-8467 | 2007-02-12 |
| 1114002177 | Michael Bruce Rulnick | Dentist | 1450 E Chestnut Ave, Suite 6 C, Vineland, NJ 08361-8467 | 2006-10-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205200755 | Caringhouse Projects, Inc | Respite Care | 1702 Gardner Street, Apt 3a & 3b, Vineland, NJ 08361 | 2015-11-20 |
| 1588038038 | Caringhouse Projects, Inc | Respite Care | 5191 East Chestnut Avenue, Vineland, NJ 08361 | 2015-11-20 |
| 1568835593 | Caringhouse Projects, Inc | Respite Care | 1718 Gardner Street, Apts 1 & 2, Vineland, NJ 08361 | 2015-11-13 |
| 1821471566 | Elwyn New Jersey | Day Training, Developmentally Disabled Services | 1667 E Landis Ave Ste 1, Vineland, NJ 08361 | 2015-06-30 |
| 1851774665 | Elwyn New Jersey | Day Training, Developmentally Disabled Services | 1667 E Landis Ave Ste 6, Vineland, NJ 08361 | 2015-06-30 |
| 1730562471 | Elwyn New Jersey | Day Training, Developmentally Disabled Services | 1667 E Landis Ave Ste 9, Vineland, NJ 08361 | 2015-06-30 |
| 1629466438 | Jadira Carlo | Counselor | Gardner Street Supervised Aparment, Vineland, NJ 08361 | 2014-12-31 |
| 1699080226 | John Platanella Jr. | Pharmacist | 1889 South Lincoln Ave., Rite Aid #10490, Vineland, NJ 08361 | 2010-08-06 |
| 1003982729 | Sheldon Vischer Smith Sr. | Internal Medicine | 1676 E Landis Avenue, Vineland, NJ 08361 | 2006-11-27 |
| 1689760951 | Tom A Tassakis | Internal Medicine | 1550 E Chestnut Ave, Building 4 Suite D, Vineland, NJ 08361 | 2006-10-05 |
| Find all providers in zip 08361 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790066108 | Daniel A Pedersen | Family Medicine | 1450e Chestnut Ave 3d, Vineland, NJ 08361-8469 | 2011-08-30 |
| 1437312394 | Alexander Antonenko | Family Medicine | 319 Landis Avenue, Vineland, NJ 08360 | 2008-07-09 |
| 1750552840 | Community Health Care, Inc | Family Medicine | 610 Montrose St, Vineland, NJ 08360 | 2008-03-17 |
| 1548310774 | The Dr Martin Jay Kessler Medical Services LLC | Family Medicine | 234 W Landis Ave, Suite 100, Vineland, NJ 08360-8109 | 2007-01-11 |
| 1982776118 | George Aristidis Dendrinos | Family Medicine | 2020 E Chestnut Ave, Vineland, NJ 08361-8432 | 2006-11-14 |
| 1629007943 | Timothy Rhyme Md LLC | Family Medicine | 1450 E. Chestnut Ave., Suite 1e, Vineland, NJ 08361 | 2006-06-30 |
| 1053354795 | John James Pastore | Family Medicine | 800 E Elmer St, Vineland, NJ 08360-4725 | 2006-06-13 |
| 1851351258 | Tri County Medicine Inc | Family Medicine | 49 S State St, Vineland, NJ 08360 | 2006-03-28 |
| 1467412858 | Raghuraj S Tomar | Family Medicine | 2815 E Chestnut Ave, Vineland, NJ 08361-8466 | 2006-03-28 |
| 1770558918 | Susan M Finder | Family Medicine | 1317 S Main Rd, 2a, Vineland, NJ 08360-6511 | 2006-02-21 |
| Find all providers in VINELAND | ||||
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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.