Theodore A Niebloom (NPI# 1689750705, PAC ID# 4789719444) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORAL SURGERY.
| Nation Provider ID (NPI) | 1689750705 |
| PAC ID by PECOS | 4789719444 |
| Professional Enrollment ID | I20100320000003 |
| Full Name | Theodore A Niebloom |
| Organization Legal Name | METROPOLITAN CRANIOFACIAL CENTER |
| Address |
101 Old Short Hills Rd Ph 2 West Orange NJ 07052-1023 |
| Phone Number | 9737367616 |
| Gender | M |
| Medical School | BOSTON UNIV GOLDMAN SCHOOL OF DENTAL MEDICINE |
| Graduation Year | 1983 |
| Primary Specialty | ORAL SURGERY |
| Secondary Specialties | MAXILLOFACIAL SURGERY |
| Group Practice PAC ID | 3577698224 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | M |
| Address | Phone | Organization |
|---|---|---|
| 199 Baldwin Rd, Suite 240, Parsippany, NJ 07054-2043 | 9733353777 | METROPOLITAN CRANIOFACIAL CENTER |
| 101 Old Short Hills Rd, Ph 2, West Orange, NJ 07052-1023 | 9737367616 | METROPOLITAN CRANIOFACIAL CENTER |
| Organization Legal Name | METROPOLITAN CRANIOFACIAL CENTER |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John P Amato | Plastic and Reconstructive Surgery | Metropolitan Craniofacial Center | 33 Clinton Rd, Suite 101, West Caldwell, NJ 07006-6790 |
| Henry J Falk | Oral Surgery | Metropolitan Craniofacial Center | 101 Old Short Hills Rd, Ph 2, West Orange, NJ 07052-1023 |
| Gary J Vitale | Oral Surgery | Metropolitan Craniofacial Center | 33 Clinton Rd, Suite 101, West Caldwell, NJ 07006-6790 |
| Street Address |
101 OLD SHORT HILLS RD PH 2 |
| City | WEST ORANGE |
| State | NJ |
| Zip | 07052-1023 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennifer D Fitzgibbons | Nurse Practitioner | Rubino Ob Gyn Group Pa | 101 Old Short Hills Rd, Suite 101, West Orange, NJ 07052-1023 |
| Irina Alekseyeva | Anesthesiology | Barnabas Health Multispecialty | 101 Old Short Hills Rd, Suite 217, West Orange, NJ 07052-1023 |
| Isaac Kramer | Internal Medicine | 101 Old Short Hills Rd, Suite 440, West Orange, NJ 07052-1023 | |
| Arya Peter Salas | Plastic and Reconstructive Surgery | Surg-elite PC | 101 Old Short Hills Rd, Suite 501, West Orange, NJ 07052-1080 |
| Lisa E Abeshaus | Obstetrics/gynecology | Rubino Ob Gyn Group Pa | 101 Old Short Hills Rd, Suite 101, West Orange, NJ 07052-1023 |
| Deborah Greengrass | Nurse Practitioner | Gynecologic Cancer and Pelvic Surgery LLC | 101 Old Short Hills Rd, Suite 400, West Orange, NJ 07052-1023 |
| Vasileios Kostaras | General Surgery | Professional Associates In Surgery, LLP | 101 Old Short Hills Rd, Suite 206, West Orange, NJ 07052-1023 |
| Priya R Patel | Obstetrics/gynecology | Rubino Ob Gyn Group Pa | 101 Old Short Hills Rd, Suite 101, West Orange, NJ 07052-1023 |
| Kimberly Klimek Ruhl | Dermatology | Deborah R. Spey, LLC | 101 Old Short Hills Rd, Suite 410, West Orange, NJ 07052-1023 |
| Ruric C Anderson Iii | Internal Medicine | Barnabas Health Medical Group PC | 101 Old Short Hills Rd, Suite 106, West Orange, NJ 07052-1023 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Steven M Hertz | Vascular Surgery | 1500 Pleasant Valley Way, Suite 302, West Orange, NJ 07052-0256 | |
| Sanjay Lalla | Plastic and Reconstructive Surgery | 383 Northfield Ave, Suite 102, West Orange, NJ 07052-0383 | |
| Cheryl S Citron | Dermatology | 101 Old Short Hills Rd, West Orange, NJ 07052-1000 | |
| Jane K Hochberg | Clinical Psychologist | 56 Herbert Ter, West Orange, NJ 07052-1021 | |
| Marisa Buonanno-hamrah | Nurse Practitioner | Gynecologic Cancer and Pelvic Surgery LLC | 101 Old Short Hills Rd, Suite 400, West Orange, NJ 07052-1023 |
| Carlos Frias | Anesthesiology | Barnabas Health Multispecialty | 101 Old Short Hills Rd, Suite 217, West Orange, NJ 07052-1023 |
| Robert J Rubino | Obstetrics/gynecology | Rubino Ob Gyn Group Pa | 101 Old Short Hills Rd, Suite 101, West Orange, NJ 07052-1023 |
| Dana M Ortiz | Obstetrics/gynecology | Rubino Ob Gyn Group Pa | 101 Old Short Hills Rd, Suite 101, West Orange, NJ 07052-1023 |
| Lawrence B Stein | Gastroenterology | Barnabas Health Multispecialty | 101 Old Short Hills Rd, Suite 217, West Orange, NJ 07052-1023 |
| Deborah Ruth Spey | Dermatology | Deborah R. Spey, LLC | 101 Old Short Hills Rd, Suite 410, West Orange, NJ 07052-1023 |
| Find all physicians in zip 07052 | |||
| City | WEST ORANGE |
| Zip Code | 07052 |
| Specialty | ORAL SURGERY |
| City + Specialty | WEST ORANGE + ORAL SURGERY |
Please comment or provide details below to improve the information on Theodore A Niebloom.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.