Justin Brackenrich (NPI# 1669852729, PAC ID# 4981959053) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1669852729 |
| PAC ID by PECOS | 4981959053 |
| Professional Enrollment ID | I20180613000495 |
| Full Name | Justin Brackenrich |
| Organization Legal Name | RIVERSIDE PEDIATRIC GROUP PC |
| Address |
935 River Rd Suite 301 Edgewater NJ 07020-2233 |
| Phone Number | 2014717012 |
| Gender | M |
| Graduation Year | 2015 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 3072650290 |
| Number of Group Practice Members | 192 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 310045 | ENGLEWOOD HOSPITAL AND MEDICAL CENTER |
| 310001 | HACKENSACK UNIVERSITY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 935 River Rd, Suite 301, Edgewater, NJ 07020-2233 | 2014717012 | RIVERSIDE PEDIATRIC GROUP PC |
| Organization Legal Name | RIVERSIDE PEDIATRIC GROUP PC |
| Physicians | 167 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ammar Haikal | Internal Medicine | Riverside Pediatric Group PC | 312 Belleville Tpke, North Arlington, NJ 07031-6463 |
| Heidi Rojas Cabrera | Nurse Practitioner | Riverside Pediatric Group PC | 506 Broadway, Bayonne, NJ 07002-3712 |
| Esther Neff Mermelstein | Nurse Practitioner | Riverside Pediatric Group PC | 609 Washington St, Hoboke, NJ 07030-4907 |
| Rebecca Siegel | Clinical Social Worker | Riverside Pediatric Group PC | 6045 Kennedy Blvd, North Bergen, NJ 07047-3246 |
| Irida Suarez | Nurse Practitioner | Riverside Pediatric Group PC | 4201 New York Ave, Union City, NJ 07087-4929 |
| Isaac Zaki | Family Medicine | Riverside Pediatric Group PC | 1111 Hudson St, Hoboken, NJ 07030-5305 |
| Stephanie Corpron | Nurse Practitioner | Riverside Pediatric Group PC | 228 Franklin Ave, Nutley, NJ 07110-4700 |
| Marie Shin | Podiatry | Riverside Pediatric Group PC | 939 Kennedy Blvd, North Bergen, NJ 07047-1870 |
| Janki P Joshi | Physical Therapy | Riverside Pediatric Group PC | 255 State Rt, Suite 3, Secaucus, NJ 07094-3857 |
| Luis Correa | Pediatric Medicine | Riverside Pediatric Group PC | 402 42nd St, Union City, NJ 07087-4960 |
| Street Address |
935 RIVER RD SUITE 301 |
| City | EDGEWATER |
| State | NJ |
| Zip | 07020-2233 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jose Luis Sabogal | Internal Medicine | Riverside Pediatric Group PC | 935 River Rd, Suite 301, Edgewater, NJ 07020-2233 |
| Patrick Khoo | Hospitalist | Riverside Pediatric Group PC | 935 River Rd, Suite 301, Edgewater, NJ 07020-2233 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nicholas D Panagiotou | Family Medicine | Waterford Towers, 190 River Road Medical Suite, Edgewater, NJ 07020 | |
| Germaine A Griswold | Psychologist, Clinical | 115 River Rd, Suite 118, Edgewater, NJ 07020-1009 | |
| Frank Santos | Psychiatry | 115 River Rd, Suite 118, Edgewater, NJ 07020-1009 | |
| Irfan M Admani | Cardiovascular Disease (cardiology) | 103 River Rd, Suite 202, Edgewater, NJ 07020-1016 | |
| Joseph David Retik | Psychologist, Clinical | The Psych Center LLC | 103 River Rd, Suite 101, Edgewater, NJ 07020-1016 |
| Brian Legg | Psychologist, Clinical | The Psych Center LLC | 103 River Rd, Suite 101, Edgewater, NJ 07020-1016 |
| Miguel A Coba | Pain Management | National Health Rehabilitation LLC | 103 River Rd, Suite 101, Edgewater, NJ 07020-1016 |
| Marc J Rosenblatt | Pain Management | National Health Rehabilitation LLC | 103 River Rd, Suite 101, Edgewater, NJ 07020-1016 |
| Joyce Cheng | Physical Medicine and Rehabilitation | National Health Rehabilitation LLC | 103 River Rd, Suite 101, Edgewater, NJ 07020-1016 |
| Yaron Bareket | Cardiovascular Disease (cardiology) | Cross County Cardiology P A | 103 River Rd, Edgewater, NJ 07020-1016 |
| Find all physicians in zip 07020 | |||
| City | EDGEWATER |
| Zip Code | 07020 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | EDGEWATER + FAMILY MEDICINE |
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| 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.