BERNADETTE MARION CRACCHIOLO (NPI# 1891721668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891721668 |
| Entity Type | Individual |
| Full Name | BERNADETTE MARION CRACCHIOLO |
| Credential | M.D. |
| Practice Address |
140 Bergen St Acc Level C Newark NJ 07103-2425 |
| Mailing Address |
30 Bergen St Admc 12 1205 Newark NJ 07107-3000 |
| Practice Telephone | 9739722700 |
| Practice Fax Number | 9739722739 |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2009-07-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
25MA06645100 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 7404204 | 05 |
| Street Address |
140 BERGEN ST ACC LEVEL C |
| City | NEWARK |
| State | NJ |
| Zip Code | 07103-2425 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871190140 | University Hospital | Podiatrist | 140 Bergen St, Newark, NJ 07103-2425 | 2020-10-08 |
| 1972159234 | University Ob/gyn Associates (om) | Obstetrics & Gynecology | 140 Bergen St, Newark, NJ 07103-2425 | 2019-08-13 |
| 1578119012 | Naji Madi | Student in an Organized Health Care Education/Training Program | 140 Bergen St, Newark, NJ 07103-2425 | 2019-08-12 |
| 1265992416 | Mary Elias | Nurse Practitioner | 140 Bergen St, Newark, NJ 07103-2425 | 2019-03-22 |
| 1275092124 | Andrew Reid Leggett | Student in an Organized Health Care Education/Training Program | 140 Bergen St, Newark, NJ 07103-2425 | 2019-03-19 |
| 1023576238 | Anh Nguyen | Student in an Organized Health Care Education/Training Program | 140 Bergen St, Newark, NJ 07103-2425 | 2019-03-06 |
| 1699201145 | John Cece | Student in an Organized Health Care Education/Training Program | 140 Bergen St, Ambulatory Care Center E1620, Newark, NJ 07103-2425 | 2017-05-03 |
| 1932634250 | Di Bai | Student in an Organized Health Care Education/Training Program | 140 Bergen St, Newark, NJ 07103-2425 | 2017-04-24 |
| 1568995009 | Chrystal Yin Chang | Student in an Organized Health Care Education/Training Program | 140 Bergen St, Ambulatory Care Center G1680, Newark, NJ 07103-2425 | 2017-04-11 |
| 1356791321 | Kari-ann Dixon | Nurse Practitioner | 140 Bergen St, Newark, NJ 07103-2425 | 2016-06-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124657077 | Yingna Liu | Student in an Organized Health Care Education/Training Program | Medical Science Building, 185 South Orange Avenue, Newark, NJ 07103 | 2020-04-03 |
| 1568029684 | Martins Akhibi | Nurse Practitioner | 178 Newton Street, Newark, NJ 07103 | 2019-05-23 |
| 1972168482 | Newark Renaissance House, Inc | Rehabilitation, Substance Use Disorder Unit | 50-56 Norfolk Street, Newark, NJ 07103 | 2019-05-09 |
| 1346709235 | Ian Wang Yu | Student in an Organized Health Care Education/Training Program | 185 South Orange Ave., Medical Science Building, Room I-506, Newark, NJ 07103 | 2019-03-19 |
| 1437648417 | Stephen Vanbeek | Internal Medicine | 185 S Orange Ave Rm 547, Newark, NJ 07103 | 2018-05-06 |
| 1073019444 | Geoffrey Alexander Talis | Student in an Organized Health Care Education/Training Program | 183 S. Orange Avenue, Level E, Room 1452, Newark, NJ 07103 | 2018-04-03 |
| 1285139907 | Thomas Georg Bachmann | Student in an Organized Health Care Education/Training Program | 185 South Orange Ave, Medical Science Building, G-538, Newark, NJ 07103 | 2018-03-26 |
| 1154825289 | Shammi A Patel | Student in an Organized Health Care Education/Training Program | 185 S Orange Ave # Msbg594, Newark, NJ 07103 | 2018-03-22 |
| 1982122545 | North Jersey Aids Alliance | Clinic/Center | 393 Central Avenue C/o Corey Destefano, Newark, NJ 07103 | 2017-09-05 |
| 1134655533 | Yasmin N Abedin | Student in an Organized Health Care Education/Training Program | 185 South Orange Ave, Msb E-506, Rutgers, New Jersey Medical School, Newark, NJ 07103 | 2017-05-04 |
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| Taxonomy Code | 207VX0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecologic Oncology |
| An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications. |
| 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 Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790786416 | Noah Adam Goldman | Obstetrics & Gynecology | 140 Bergen Street, Level C, Newark, NJ 07103 | 2005-08-03 |
| 1144229733 | Nicholas Reed | Obstetrics & Gynecology | 15 Messimer Dr, Newark, OH 43055-1841 | 2005-07-18 |
| 1386871689 | Jenna Z Marcus | Obstetrics & Gynecology | 185 S Orange Ave, Medical Science Building E536, Newark, NJ 07103-2757 | 2009-06-15 |
| 1548468259 | Stephanie Jean | Obstetrics & Gynecology | 4701 Ogletown Stanton Rd, Helen F. Graham Cancer Center West, S-2335, Newark, DE 19713-2055 | 2007-07-03 |
| 1811191604 | Akiva Pesach Novetsky | Obstetrics & Gynecology | 140 Bergen St # C, Newark, NJ 07103-2425 | 2007-06-13 |
| 1982628111 | Charles W Whitney | Obstetrics & Gynecology | 4923 Ogletown Stanton Rd, Suite 110, Newark, DE 19713-2081 | 2006-07-27 |
| 1912921149 | James E Larson | Obstetrics & Gynecology | 4923 Ogletown Stanton Rd, Suite 110, Newark, DE 19713-2081 | 2006-07-27 |
| 1730102914 | Christiana Gynecologic Oncology, LLC | Obstetrics & Gynecology | 4923 Ogletown Stanton Rd, Suite 110, Newark, DE 19713-2081 | 2006-07-26 |
| 1225068372 | Mario Mendes Leitao Jr. | Obstetrics & Gynecology | 30 Bergen St, Admc 12 1205, Newark, NJ 07107-3000 | 2006-07-04 |
| 1629058201 | Nicholas Petrelli | Obstetrics & Gynecology | 4701 Ogletown Stanton Rd, Suite 1213, Newark, DE 19713-2055 | 2006-01-19 |
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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.