| Firm and/or Individual |
Category/Reason |
Action/By |
Effective |
Expiration |
AARON, ALLISON (LPN)
113 E. 22ND AVENUE
NORTH WILDWOOD, NJ 08260
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/6/2025 |
|
ABARCA, CHERYL R. (LPN)
528 3RD STREET
NEWARK, NJ 07107
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2005 |
|
ABASHKIN, ROMAN (CHHA)
72 RIDGEVIEW TERRACE
WAYNE, NJ 07470
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/29/2015 |
|
ABASHKIN, ROMAN (CHHA)
72 RIDGEVIEW TERRACE
WAYNE, NJ 07470
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/3/2016 |
|
ABBASSI, JADAN (MD)
1618 MAIN AVENUE
CLIFTON, NJ 07011
NPI-1194807255 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/21/2016 |
Permanent |
ABBASSI, JADAN (MD)
115 NELLIS DRIVE
WAYNE, NJ 07470
NPI-1194807255 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/20/2018 |
Permanent |
ABDALLA, FARIDA (CHHA)
558 ALLWOOD ROAD, APT. 2
CLIFTON, NJ 07012
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/28/2023 |
|
EMPIRE STATE MED. SVC INC
1116 ANNE STREET
ELIZABETH, NJ 07201ABDALLA, IZZELDIN
1116 ANNE STREET
ELIZABETH, NJ 07201
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/10/1999 |
Permanent |
ABDELAZIZ, HATEM H.
77 TWIN OAKS OVAL
SPRINGFIELD, NJ 07081
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/5/2024 |
11/11/2025 |
ABDELAZIZ, HATEM H.
77 TWIN OAKS OVAL
SPRINGFIELD, NJ 07081
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/12/2025 |
Permanent |
ABDELGANI, AMIR
ALLENWOOD USP
WHITE DEER, PA 17887
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/26/2001 |
|
ABDELGANI, FADIL
TERRE HAUTE USP
TERRE HAUTE, IN 47808
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/26/2001 |
Permanent |
ABDELGAWAD, WALAA SALAH MOUHAMD (CHHA)
64 TURES AVENUE, APT. 1D
JERSEY CITY, NJ 07306
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/4/2023 |
|
ABDELHAMID, MANAL (RPH)
7100 BOULEVARD EAST, 11G
GUTTENBERG, NJ 07093
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/15/2001 |
Permanent |
ABDELMALAK, MAGDAH (CHHA)
39 DALES AVENUE, APT. 634
JERSEY CITY, NJ 07306
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/4/2023 |
|
ABDELRAHMAN, EMAN F. (CHHA)
47 GALES DRIVE
NEW PROVIDENCE, NJ 07974
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/17/2023 |
|
ABDOLLAHI, MITRA (DMD)
646 N. SARATOGA DRIVE
MOORESTOWN, NJ 08057
NPI-1033329230 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/5/2007 |
7/19/2019 |
ABERBACH, STEVEN (RPH)
23 STONEGATE DRIVE
WATCHUNG, NJ 07069
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/19/2003 |
|
ABOOD, ABDOLMAID S.
64 BEVAN STREET
JERSEY CITY, NJ 07306
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
5/7/1997 |
|
ABOUELHODA, AHMED (RPH)
33-17 60TH ST. APT. 1
WOODSIDE, NY 11377
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2005 |
|
ABRAHAMSEN, SVEND (DPM)
101 CHESTNUT RIDGE ROAD
SADDLE RIVER, NJ 07458
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/20/1994 |
Permanent |
ABRAMS, DE'NYSHIA (CHHA)
410 3RD AVENUE, APT. 1A
ASBURY PARK, NJ 07712
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/16/2018 |
|
ABRAMS, IRVING (RPH)
5 LORGENE WAY
MORGANVILLE, NJ 07551
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/27/2000 |
|
ABREU DE AGRAMONTE, YASMIN (CHHA)
547 E. 24TH STREET
PATERSON, NJ 07514
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/26/2024 |
|
ABREU MARTINEZ, CAROLINA (CHHA)
14 EAST RUSSELL STREET
CLIFTON, NJ 07011
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/31/2017 |
|
ABUROMI, RASHA ALI (CHHA)
19010 BROWNSTONE MILLS DRIVE
CYPRESS, TX 77433
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/4/2023 |
|
SUTEX MEDICAL TRANSPORT
814 74TH STREET
NORTH BERGEN, NJ 07047ABUSEF, ELSAYED K.
814 74TH STREET
NORTH BERGEN, NJ 07047
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/1999 |
Permanent |
ACKLEY, GEORGE (PSYCH)
202 LENOX AVENUE
CAPE MAY , NJ 08204
NPI-1457535833 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/21/2015 |
|
ACOSTA, LEILANI (CHHA)
458 STEVENSON PLACE, FLOOR 1
PERTH AMBOY, NJ 08861
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/9/2019 |
|
ACOSTA, PEDRO E.
5815 43RD AVENUE 1ST FL
QUEENS, NY 11377
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2008 |
|
ACOSTA, PEDRO E.
5815 43RD AVENUE 1ST FL
QUEENS, NY 11377
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/13/2008 |
|
ACOSTA, PEDRO E.
5815 43RD AVENUE 1ST FL
QUEENS, NY 11377
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/16/2011 |
|
ACOSTA, WILLIAM R. (MD)
47 OSBORNE STREET
JOHNSTOWN, PA 15905
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
ACQUAH, ROSE AKA MANFORD, ROSE (CHHA)
5507 WARNER VIEW LANE
WESTVILLE, OH 43081
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/13/2018 |
|
ACQUAIRE, FLORENCE
EMCF PO BOX 08809
CLINTON, NJ 08809
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/20/2006 |
|
ACQUAYE, EDWARD
10 BERWICK CIRCLE
NORTH BRUNSWICK, NJ 08902
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/19/2007 |
|
ACZON, FERDINAND B. (MD)
204 SUMMIT ROAD
MOUNT LAUREL, NJ 08054
NPI-1255422135 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2011 |
11/23/2016 |
ADADEVOH, LOVESDALE AKA HAMENOO, LOVESDALE (CHHA)
1 SKYTOP GARDENS, APT. 19
PARLIN, NJ 08859
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/16/2019 |
|
ADAIR, LISA AKA TARASEVICH, LISA (LPN)
206 LAKEHURST AVE., APT.B
NATIONAL PARK, NJ 08063
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2002 |
|
ADAMS, AMELIA (CHHA)
132 OAKMONT ROAD
CLEMENTON, NJ 08021
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
ADAMS, ANTOINETTE (CHHA)
1604 SEWALL AVENUE
ASBURY PARK, NJ 07712
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
ADAMS, JAIME L. (CHHA)
911 W. HAND AVE
CAPE MAY CT. HS, NJ 08210
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/19/2003 |
|
ADAMSHICK, WILLIAM (RPH)
2516 HURRY ROAD.
FORKED RIVER, NJ 08731
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/14/2005 |
3/21/2012 |
ADDIS, DAVID J. (MD)
334 FARNSWORTH AVENUE
BORDENTOWN, NJ 08505
NPI-1770656068 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/20/2015 |
Permanent |
ADES, ALBERT (DR'S OFFICE)
MIAMI FCI, PO BOX 779800
MIAMI, FL 33177
NPI-1447560867 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/16/2017 |
|
ADES, ALBERT (MD)
3 MARKHAM CIRCLE
ENGLEWOOD, NJ 07631
NPI-1912069394 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/16/2016 |
|
ADES, ALBERT (MD)
PO BOX 779800, #67194-050
MIAMI, FL 33177
NPI-1912069394 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/12/2016 |
|
ADISSON, LECLERC (MD)
1482 SW 150TH TERRACE
SUNRISE, FL 33326
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2007 |
Permanent |
ADISSON, LUNIC (CHHA)
14 WALTER PLACE #1
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/14/2008 |
Permanent |
ADOLPHE, NAOMIE (CHHA)
410 FISHER AVENUE
NEPTUNE, NJ 07753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
ADU-BOAHENE, KWABENA (CHHA)
3 AUGUSTA DRIVE
LITTLE EGG HARBOR, NJ 08087
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/23/2018 |
|
AFRIYIE, BRIGHT (CHHA)
317 W. RUNYON STREET, 3L
NEWARK, NJ 07108
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/23/2018 |
|
AFZAL, FIAZ (MD)
1000 VETERANS MEMORIAL BLVD
KENNER, LA 70062
NPI-1003801044 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/6/2022 |
|
AFZAL, TAHIR
2016 DIXON ROAD
FREDERICK, MD 21704
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/19/2024 |
|
AGARWAL, SHASHI K. (MD)
FCI SCHUYLKILL, PO BOX 759
MINERSVILLE, PA 17954
NPI-1558416099 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
2/28/2014 |
|
AGARWAL, SHASHI, K. (MD)
198 CENTRAL AVENUE 1ST FL
EAST ORANGE, NJ 07018
NPI-1558416099 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
10/22/2012 |
|
AGBOGE, EBOWA (CHHA)
111 TELFORD STREET, APT. 2
NEWARK, NJ 07106
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/28/2023 |
|
Agostino Ducato, VP
,
NPI- |
Medical
Other |
|
|
|
AGRAWAL, PANKAJ (MD)
3 E MEADOWBROOK CIRCLE
SICKLERVILLE, NJ 08081
NPI-1962661215 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/11/2006 |
|
AGRESTA JR., RUDOLPH (MD)
P.O. BOX 7450
TRENTON, NJ 08628
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/19/2004 |
|
AGRESTI, JAMES (MD)
292 FAIRMONT ROAD
LONG VALLEY, NJ 07853
NPI-1255389813/1477874352 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/5/2020 |
|
AGRESTI, ROBERT (MD)
15 BARBERRY WAY
ESSEX FALLS, NJ 07021
NPI-1619155710 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/26/2018 |
|
AGUH, CHIKEZIE (MD)
18 MULBERRY COURT
BELLE MEAD, NJ 08502
NPI-1407876261/1619997483 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/11/2021 |
|
AGUIAR, SANDRA
605 KNICKERBOCKER ROAD
TENAFLY, NJ 07670
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/18/2009 |
|
AGUILAR, RUBEN (RPH)
16 GOLDENROD DRIVE
BELLE MEAD, NJ 08502
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
7/20/2010 |
|
AGUIRRE-MEDRANO, CANDIDA
40 FERRY STREET
NEWARK, NJ 07105
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/12/1999 |
Permanent |
AGYEMANG, JOHN (RPH)
153 BLUE MEADOW LANE
SICKLERVILLE, NJ 08081
NPI-1487934626 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/28/2016 |
9/22/2020 |
VICTORY PHARMACY
94 MARKET STREET
NEWARK, NJ 07102AGYEMANG, KWADWO (RPH)
94 MARKET STREET
NEWARK, NJ 07102
NPI-1154713394 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/25/2003 |
6/3/2015 |
AHLAWAT, RANVIR (MD)
2204 ARVELL STREET
TOMS RIVER, NJ 08755
NPI-1447204615 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/19/2016 |
9/14/2021 |
AHMAD, ABADULLAH
280 LUIS MARIN BLVD #15
JERSEY CITY, NJ 07302
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/19/2009 |
Permanent |
AHMAD, FAROOQ (RPH)
300 EAST HALSEY ROAD
PARSIPPANY, NJ 07054
NPI-1659605590 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/8/1994 |
|
GARDEN DRUGS INC./NEW HEALTH CARE PHARM./SAIRA SONIA INC.
682 BERGEN AVENUE
JERSEY CITY, NJ 07306AHMAD, NAEEM S.
682 BERGEN AVENUE
JERSEY CITY, NJ 07306
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/15/1983 |
Permanent |
AHMAD, NAVEED (MD)
48 SUYDAM ROAD
SOMERSET, NJ 08873
NPI-1669412946 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/29/2016 |
Permanent |
AHMAD, NAVEED (MD)
48 SUYDAM ROAD
SOMERSET, NJ 08873
NPI-1669412946 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/20/2016 |
Permanent |
AHMED, AMIR E.
7-11 TONNELLE AVE - 2MN
JERSEY CITY, NJ 07306
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
5/30/1997 |
Permanent |
AHMED, FARHANA (CHHA)
193 PATERSON AVENUE, APT. 1
PATERSON, NJ 07502
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/28/2023 |
|
AHMED, KHALID H.
PO BOX 930
NEW YORK, NY 10013
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/26/1994 |
Permanent |
AHMED, MOHAMED G. (PHARM TECH)
5 WESTOVER TERRACE
WEST ORANGE, NJ 07052
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2010 |
|
AIRD, EILEEN B.
295 GRANDVIEW CIRCLE
RIDGEWOOD, NJ 07450
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/20/2003 |
|
AIYEGBAYO, ABIOLA J. aka OMISHORE, ABIOLA J. (RN)
5 CHESTNUT STATE
EAST BRUNSWICK, NJ 08816
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/17/2024 |
|
AJAO, ABIOLA (CHHA)
687 S 20TH STREET, APT. 3
NEWARK, NJ 07103
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/28/2023 |
|
AKANDE, EZEKIEL (MD)
300 HAIL KNOB ROAD, #290828
SOMERSET, KY 42503
NPI-1003859885 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2017 |
|
AKHMEDOV, KHUSEN
SCI GRATERFORD, ME9849, PO BOX 244
GRATERFORD, PA 19426
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
AKHTAR, NADEEM (RPH)
15 GRIST MILL LANE
UPPER SADDLE RI, NJ 07458
NPI-1063695963 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
1/20/2012 |
|
AKHTAR, NADEEM (RPH)
15 GRISTMILL LANE
UPPER SADDLE RI, NJ 07458
NPI-1063695963 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2012 |
|
AKINBILE, MORUFU O. (RN)
419 E. MOOREHAVEN DRIVE
CARSON, CA 90746
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2010 |
|
AKODA, CHARLES AKA IGBERASE, OLUWAFEMI AKA IGBERASE, CHARLES (RN)
14909 DOWNEY COURT, SUITE 200
BOWIE, MD 20721
NPI-1609033042 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2018 |
|
AL SALIHI, FAROUK (MD)
1810 JOHN F. KENNEDY BLVD
JERSEY CITY, NJ 07305
NPI-1720158025 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/1/2011 |
|
AL SALIHI, FAROUK (MD)
1810 JOHN F. KENNEDY BLVD
JERSEY CITY, NJ 07305
NPI-1720158025 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/9/2015 |
|
ALAM, HAMID (MD)
775 LISA CIRCLE, APT 11
HUNTINGDON VALLEY, PA 19006
NPI-1285659649 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
10/25/2023 |
|
ALAM, HAMID M. (MD)
25 SULLIVAN DRIVE, APT A66
JERICHO, NY 11753
NPI-1285659649 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2024 |
|
TEMPT TRANSIT, INC.
238 MAIN STREET
HACKENSACK, NJ 07601ALAMEEN, ALWALEED
238 MAIN STREET
HACKENSACK, NJ 07601
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/18/1995 |
|
ALAN, DAVID
203 NORTH REDWOOD STREET
MASONTOWN, PA 15461
NPI-1225012073 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
ALARIO, FRANK CHARLES (MD)
4865 N CLASSICAL BLVD
DELRAY BEACH, FL 33445
NPI-1194740225 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/18/2024 |
|
ALBERS, HENRY J. (EMT)
3 QUEEN STREET
PARSIPPANY, NJ 07054
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/9/1996 |
Permanent |
ALBINO, ETHAN (RN)
224 FERN AVENUE
HADDON TOWNSHIP, NJ 08108
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/7/2017 |
|
ALCAIDE, KELLY (LPN)
716 RIVER ROAD
SOMMERVILLE, NJ 08844
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/20/2002 |
|
ALCANTARA, MARIA CHRISTINE (CNA)
1021 ROUTE 166
183504, NJ 08753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/22/2023 |
Permanent |
ALEXANDER, EDWARD J. (MD)
8001 CASTOR AVE., STE 326
PHILADELPHIA, PA 19152
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
8/8/2000 |
Permanent |
ALEXANDER, JULIE B. (RPH)
1525 DOGWOOD DRIVE
CHERRY HILL, NJ 08003
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/19/2005 |
|
ALEXANDRA, ALYCIA AKA DOTRO, ALYCIA (RN)
6 LOWELL ROAD
MANALAPAN, NJ 07726
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/23/2019 |
|
ALFONSO, NORMA (CHHA)
144 SUMMIT STREET
ENGLEWOOD, NJ 07631
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/19/1997 |
|
AL-GHRAOUI, FADI (MD)
PO BOX 23429
FORT LAUDERDALE, FL 33307
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/18/2004 |
DECEASED |
ALI, HANIFAH (CHHA)
1216 FALCON DRIVE
ABSECON, NJ 08201
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
ALI, MOHAMED T. (MD)
64 BEVAN STREET
JERSEY CITY, NJ 07306
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/31/1994 |
Permanent |
ALI, RAUSHANAH (LPN)
103 BONNIA AVENUE
TRENTON, NJ 08629
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/3/2019 |
|
ALI, SAMIRA (CHHA)
242 CLAREMONT AVENUE, APT. 6
JERSEY CITY, NJ 07305
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/28/2023 |
|
ALI, SAQIB
MDC BROOKLYN, PO BOX 3290
BROOKLYN, NY 11232
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
5/20/2012 |
|
TARIK TRANSPORTATION SVC.
566 BLOOMFIELD AVENUE
BLOOMFIELD, NJ 07306ALI, TARIK
566 BLOOMFIELD AVENUE
BLOOMFIELD, NJ 07306
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/10/1999 |
Permanent |
ALLEN, ADINA (CHHA)
219 PINEBROOK DRIVE
MANTUA, NJ 08051
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/22/2017 |
|
ALLEN, DEBRA (CHHA)
18 REID LANE
MILLSTONE TWP. , NJ 08535
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/6/2019 |
Permanent |
ALLEN, KENNYATTA G.
148 CORNERSTONE PLACE
WHITEHALL, NY 18052
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/14/2008 |
|
ALLEN, MICHELLE I. (RN)
306 LUKE FIDLER ROAD
RENSHAW, PA 17866
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/31/2023 |
|
ALLEN-BROGAN, MELANIE A.
135 WILD OAKS COURT
LITTLE EGG HARB, NJ 08701
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/5/2008 |
|
ALLRED, ELLEN ANNE (RN)
571 FERNWOOD AVENUE
FAIRLESS HILLS, PA 19030
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
ALPERIN PEDIATRICS, PA
28 RIVERSIDE AVENUE
RED BANK, NJ 07701ALPERIN, MARTIN (MD)
28 RIVERSIDE AVENUE
RED BANK, NJ 07701
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/19/2000 |
Permanent |
ALPERT, PERRY (DDS)
560 NEWARK AVENUE
ELIZABETH, NJ 07208
NPI-1952668782 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/2/1995 |
8/26/2020 |
ALSTON, SHERRELLE
NORTH 52ND STREET
PHILADELPHIA, PA 19139
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
10/9/2007 |
|
ALSUMMAGHIA, NATHEM (CHHA)
155 W 49th STREET
BAYONNE, NJ 07002
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/31/2023 |
|
ALTOONIAN, ANN MARIE (RN)
82 CONTANT AVENUE, APT. 2
LODI, NJ 07644
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/11/2019 |
|
ALVIS, SANDRA (CHHA)
1421 HOLLINSHED AVENUE
PENNSAUKEN, NJ 08110
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/19/2005 |
|
CRESCENT EXPRESS
24 BRANFORD PLACE
NEWARK, NJ 07102ALY, ABUBAKR
24 BRANFORD PLACE
NEWARK, NJ 07102
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/11/2004 |
|
ALY, AHMED F. (RPH)
1030 LIBERTY AVENUE
UNION, NJ 07083
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/17/2007 |
|
CLIFTON FAMILY PHARMACY
1137 MAIN AVENUE
CLIFTON, NJ 07011ALY, WAEL
1137 MAIN AVENUE
CLIFTON, NJ 07011
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
5/30/2000 |
|
OMARS PHARMACY, INC.
1137 MAIN AVENUE
CLIFTON, NJ 07011ALY, WAEL
1137 MAIN AVENUE
CLIFTON, NJ 07011
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
5/30/2000 |
|
AMABILE, JOHN C. (OD)
HIGHWAY #35 & 3RD AVENUE
OCEAN, NJ 07712
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/30/2002 |
Permanent |
AMAKER, PHYLLIS (CHHA)
475 LIVINGSTON DRIVE
EAST WINDSOR, NJ 08520
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
AMANKWAH, VINCENTIA
8 MAPLES AVENUE
CLIFFWOOD, NJ 07721
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/28/2017 |
|
AMANKWAH, VINCENTIA
8 MAPLES AVENUE
CLIFFWOOD, NJ 07721
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/1/2016 |
|
AMATO, CARLO (DC)
500 RIVER AVENUE
LAKEWOOD, NJ 08701
NPI-1275673360 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/18/2018 |
|
AMATO, NICOLA (DC)
3 MULLIGAN DRIVE
FLANDERS, NJ 07836
NPI-1366941627 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2005 |
12/19/2023 |
AMATO, STEVEN P. (DC)
30151 FISH ROCK ROAD
YORKVILLE, CA 95494
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/20/2009 |
|
AMATO, VANESSA A. AKA NOWINSKI, VANESSA (RN)
65 LOCUST AVENUE
N. ARLINGTON, NJ 07031
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2003 |
|
AMBROSE, DEAN A. (DO)
119 NORTH CETNTRE STREET
MERCHANTVILLE, NJ 08109
NPI-1598832560 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/1/2002 |
|
AMENYITOR, APEAFA (CHHA)
14 MARSHALL STREET, APT. 14W
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
AMES, TISHEENA (CHHA)
96 HALSEY REED ROAD
CRANBURY, NJ 08512
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/28/2018 |
|
AMIN, JASHVANT (MD)
8 SUNSET ROAD
WEST CALDWELL, NJ 07006
NPI-1922116268 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/22/2023 |
Permanent |
AMIN, PRISCILLA (CHHA)
133 ATLANTIC STREET
HACKENSACK, NJ 07601
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/23/2017 |
|
AMMAR, TAMESHWAR (MD)
805 BROADWAY FL 1
AMITYVILLE, NY 11701
NPI-1366478943 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/15/2022 |
|
AMON, TAMERLANE (CNA)
394 EGE AVENUE
JERSEY CITY, NJ 07304
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/16/2018 |
|
AMON, TAMERLANE (CNA)
394 EGE AVENUE
JERSEY CITY, NJ 07304
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/18/2019 |
|
AMPARO, VIANNE AKA PAYANO, VIANNE (CHHA)
710 EAST 18TH STREET
PATERSON, NJ 07501
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
AMPOFO, TWUMASI
12 MARSHALL STREET #7W
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/1/2008 |
|
AMPOFO, TWUMASI
12 MARSHALL STREET #7W
IRVINGTON, NJ 07111
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/30/2009 |
|
ANAND, NEIL (MD)
26 TAFT LANE
MORRISTOWN, NJ 07960
NPI-1982626818 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/18/2019 |
|
ANAND, SUBINA (DMD)
17 GROVERS MILL ROAD
IRVINGTON, NJ 07111
NPI-1982781589 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/20/2012 |
|
ANAND, SUBINA (DMD)
17 GROVERS MILL ROAD
PLAINSBORO, NJ 08536
NPI-1982781589 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/17/2012 |
|
ANDERSON, CHARMAINE (RN)
95 FARRAGUT ROAD
NORTH PLAINFIELD, NJ 07062
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/28/2017 |
|
ANDERSON, DAVID (RN)
519 HOBART AVE.
TRENTON, NJ 08629
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2003 |
|
ANDERSON, FRANCINE (CHHA)
901 PRINCETON AVENUE
LAKEWOOD, NJ 08701
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/12/2018 |
|
ANDERSON, JOHN P. (MD)
362 S. LAUREL STREET
WAYNEBORO, VA 22980
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/20/1999 |
|
ANDERSON, NICOLE (RN)
1801 HUNTINGTON MEWS
CLEMENTON, NJ 08021
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/28/2017 |
|
ANDRADE, GLORIA (LCSW/LCADC)
679 GRANT TERRACE
TEANECK, NJ 07666
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/18/2018 |
|
ANDREWS, JEFFREY
8 CUSHMAN ROAD
ROSEMONT, PA 19010
NPI- |
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/4/2024 |
|
ANDREWS, TANELLE (RN)
1340 S. ORCHARD ROAD
VINELAND, NJ 08360
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/25/2019 |
|
ANDUJAR, EDWARD (MD)
516 E. WOOD STREET
VINELAND, NJ 07410
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/20/2006 |
|
ANELLO, ALLYSON (PHARM TECH)
708 FOX HILL DRIVE
DOVER, NJ 07801
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/5/2018 |
Permanent |
ANEROUSIS, MARY DEE (DDS)
283 SOUTH ORANGE AVENUE
LIVINGSTON, NJ 07039
NPI-1871675769 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2019 |
|
ANGEL, CHRISTINA (CHHA)
145 PRESIDENTIAL BOULEVARD, APT. 16J
PATERSON, NJ 07522
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
ANGELES, KATHERINE (MD)
191 ROUTE 37 WEST
TOMS RIVER, NJ 08755
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/23/1995 |
DECEASED |
ANGELO, JOSEPH
34 STONEHEDGE ROAD
LINCROFT, NJ 07738
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/27/1993 |
Permanent |
ANODIDE, PAUL A. (DDS)
23 BLUE DEVIL LANE
TRENTON, NJ 08619
NPI-1841317625 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/3/2006 |
|
ANSERE, PATIENCE (CHHA)
305 COOLIDGE AVENUE
ENGLEWOOD, NJ 07631
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/17/2018 |
|
ANTELL, CLIFF #65502-050
FCI CUMBERLAND, PO BOX 1000
CUMBERLAND, MD 21501
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/18/2019 |
|
ANTHONY, QUINT (LPN)
PO BOX 214
BAYVILLE, NJ 08721
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/5/2017 |
|
ANTONE, JULIE (LCSW)
366 CAMBRIDGE DRIVE
RAMSEY, NJ 07446
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
2/20/2013 |
5/25/2023 |
ANTWI, ISAAC (CHHA)
549 BOLTON AVENUE #1
BRONX, NY 10473
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/28/2018 |
10/21/2025 |
ANZALONE, ANTHONY (MD)
203 DIETZ STREET
CRANFORD, NJ 07016
NPI-1124071857 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2019 |
|
APONTE, DENNIS (MD)
MDC BROOKLYN - PO BOX 329002
BROOKLYN, NY 11232
NPI-1053458018 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2015 |
|
APPIAH-KUBI, LESLIE (LPN)
1457 OGDEN AVENUE, APT 2H
BRONX, NY 10452
NPI-1205351582 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2023 |
3/23/2026 |
AQUILANTE, JOHN C. (RPH)
27 ROCKLEDGE PLACE
CEDAR GROVE, NJ 07009
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/23/1983 |
Permanent |
ARDAN, MARGO (RN)
161 CONAWAGA TRAIL
MEDFORD, NJ 08055
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/28/2017 |
|
ARDEHALI, MOHAMMED (MD)
193 ELMWOOD AVENUE
NEWARK, NJ 07104
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/20/2001 |
|
ARGUETA, ALVARO (MD)
9408 BIG VIEW DRIVE
AUSTIN, TX 78730
NPI-1194851618 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/22/2017 |
Permanent |
ARGUETA, EDWARD A. (CNA)
604 N. BAYVIEW AVENUE
SEASIDE PARK, NJ 08752
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/13/1999 |
|
ARGUETA, EDWARD A. (CNA)
604 N. BAYVIEW AVENUE
SEASIDE PARK, NJ 08752
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
4/8/1999 |
|
ARIF, MOHAMMED
147-14 14TH AVENUE
WHITESTONE, NY 11375
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
ARMANI, MEHDI a/k/a MEHDI NIKPARVAR-FARD a/k/a MEHDI NIKPARVARFARD
PHILADELPHIA FDC, P.O. BOX 562
PHILADELPHIA, PA 19105
NPI-1699761353 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/2024 |
|
ARMBRISTER, KATIMA (CHHA)
301 BELMAR AVENUE
NEPTUNE, NJ 07753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
ARNESON, VICTORIA (RN)
42 HOLLY STREET
CRANFORD, NJ 07016
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2003 |
|
AROWOSAYE, EMILY (RN)
24 CUNNINGHAM DRIVE
WEST ORANGE , NJ 07052
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/31/2010 |
|
AROWOSAYE, EMILY (RN)
24 CUNNINGHAM DRIVE
WEST ORANGE, NJ 07052
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
5/20/2012 |
|
AROWOSAYE, ISAAC
24 CUNNINGHAM DRIVE
WEST ORANGE, NJ 07052
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
7/4/2014 |
DECEASED |
ASARE, PATIENCE (CHHA)
971 US HIGHWAY 9N., APT 5-1L
PARLIN, NJ 08859
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/25/2025 |
Permanent |
ASHOKAN, ANNAMALAI (MD)
7 ROCKLEDGE DRIVE
SUFFERN, NY 10901
NPI-1497857270 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/1/2004 |
|
ASKANAZI, JEFFREY (MD)
2322 OLDE FARM LANE
HUDSON, OH 44236
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/19/1999 |
Permanent |
ASLAM, ZAHID (MD)
1814 E. 2ND STREET
SCOTCH PLAINS, NJ 07076
NPI-1306906854 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/16/2019 |
Permanent |
ASTON, ALEXIA L. (LPN)
15 PRIMROSE LANE, APT. 3
DELRAN, NJ 08075
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/18/2009 |
|
ASTORE, MARYANN (CHHA)
45 KOHOMO AVENUE
ERIAL, NJ 08081
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/30/2019 |
|
ATIENZA, CESAR P. (MD)
56 COLD INDIAN SPRING RD
OCEAN, NJ 07712
NPI-1164491494 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/6/1991 |
Permanent |
ATIYAS SR., LIOR A. a/k/a DAVID COHEN
136 LEFFERTS ROAD
WOODMERE, NY 11598
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2024 |
|
ATKINS, DAWN AKA STILL, DAWN (CHHA)
697 EVERETT STREET
CAMDEN, NJ 08104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/6/2018 |
|
AUFSEESER, LESLIE (DPM)
111 MEADOWS LANE
WAYSIDE, NJ 07712
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/12/2018 |
|
AURANGZEB, MUHAMMED
2330 ROUTE 33, SUITE 311
TRENTON, NJ 08691
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/2/2023 |
|
AUSTIN, BRITTANY (CHHA)
420 N. SOUTH CAROLINA AVENUE
ATLANTIC CITY, NJ 08401
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/6/2018 |
|
GERI CARE CENTERS INC
31 MADISON AVENUE
MONTCLAIR, NJ 07042AUSTIN, DONALD P
31 MADISON AVENUE
MONTCLAIR, NJ 07042
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
AUSTIN, NIDERIA (CHHA)
822 GALINDEZ COURT
CAMDEN, NJ 08102
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/15/2017 |
|
AVETIAN, CHARLES GARO aka AVETIAN, GARO CHARLES (MD)
2 MILL COURT
NEWTOWN SQUARE, PA 19073
NPI-1013936400 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2023 |
|
AVICOLLI, NICHOLAS (RPH)
985 PAPEN ROAD
BRIDGEWATER, NJ 08807
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/19/2022 |
|
AVILES, REBECCA (CHHA)
67 MILL ROAD
LEVITTOWN, PA 19057
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
AWELEWA, FUNMI M a/k/a OBADUN, FUNMI MODUPE
80 TELFORD STREET
NEWARK, NJ 07106
NPI-1811399397 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2024 |
|
AYALA, ANDRES
33 MADISON AVENUE
CHERRY HILL, NJ 08002
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/11/2017 |
10/3/2019 |
AYALA, ANDRES
33 MADISON AVENUE
CHERRY HILL, NJ 08002
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/3/2019 |
|
AYODELE, SIMISOLA (CHHA)
165 N 6TH STREET
NEWARK, NJ 07107
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/17/2023 |
|
AZAM, CHOWDHURY F. (MD)
38 ORIOLE DRIVE
HACKETTSTOWN, NJ 07840
NPI-1922053792 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/1/1999 |
6/30/2015 |
AZAM, CHOWDHURY F. (MD)
30 DUNSTON LANE
MONMOUTH JUNCTION, NJ 08852
NPI-1922053792 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/26/2016 |
|
AZEEZ, ALABA (CHHA)
806 S 16TH STREET, FLOOR 2
NEWARK, NJ 07108
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/5/2023 |
4/22/2025 |
AZER, MERFAT (CHHA)
335 ARMSTRONG AVENUE, FLOOR 2
JERSEY CITY, NJ 07305
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2023 |
|
AZIZ-DURRANI, MUMLIKAT
328 SIP AVENUE
JERSEY CITY, NJ 07306
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2002 |
|
GOODWILL PHARMACY
2836 DEBRA WAY
UNION, NJ 07083AZU, PHILIP N. (RPH)
2836 DEBRA WAY
UNION, NJ 07083
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/1999 |
Permanent |
AZU, PHILIP N. (RPH)
1094 CLINTON AVENUE
IRVINGTON, NJ 07111
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/19/2001 |
Permanent |
AZZAM, DOAA (CHHA)
10 LAKE AVENUE
PATERSON, NJ 07503
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/5/2023 |
|
BABARIA, ASHOKKUMAR (MD)
FCI FORT DIX PO BOX 2000
FORT DIX, NJ 08640
NPI-1538100599 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/4/2014 |
|
BABARIA, ASHOKKUMAR (MD)
5756 HARTFIELD/POINTVILLE
FORT DIX, NJ 08640
NPI-1538100599 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/28/2015 |
|
BABARIA, ASHOKKUMAR (MD)
208 QUAKERBRIDGE COURT
MOORESTOWN, NJ 08057
NPI-1538100599 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
1/10/2012 |
|
BABAYANTS, ALEXANDER (MD)
184 S. LIVINGSTON AVENUE #9272
LIVINGSTON, NJ 07039
NPI-1194779371 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/10/2018 |
10/21/2021 |
BABBITT, GRANT (DC)
120 SOUTH MARTINE AVENUE
FANWOOD, NJ 07023
NPI-1811077092 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/4/2025 |
Permanent |
BACHA, DAVID (DO)
240 E. PALISADES AVENUE, APT 5E
ENGLEWOOD CLIFFS, NJ 07631
NPI-1629179007 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/11/2025 |
Permanent |
BACHIR, AHMED M. (RPH)
1070 MORRIS AVENUE, APT 1224
UNION, NJ 07083
NPI-1720443674 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/19/2024 |
|
BACSENKO, JENNIFER (PHARM TECH)
103 STATE STREET
LINWOOD, NJ 08221
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/20/2011 |
|
BADAWT, BADAWY AKA BADAWY BADAWY (MD)
2738 KENNEDY BOULEVARD 1ST FL
JERSEY CITY, NJ 07306
NPI-1679615553 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/11/2016 |
|
BADAWT, BADAWY AKA BADAWY BADAWY (MD)
2738 KENNEDY BLVD 1ST FL
JERSEY CITY, NJ 07306
NPI-1679615553 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
3/25/2013 |
|
BADAWY, BADAWY AKA BADAWY BADAYT (MD)
2738 KENNEDY BOULEVARD 1ST FL
JERSEY CITY, NJ 07306
NPI-1679615553 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/11/2016 |
|
BADAWY, BADAWY AKA BADAWY BADAYT (MD)
2738 KENNEDY BLVD 1ST FL
JERSEY CITY, NJ 07306
NPI-1679615553 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
3/25/2013 |
|
BADAWY, HOSSAM (CHHA)
51 SMITHFIELD DRIVE
SPRINGFIELD, NJ 07081
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/4/2023 |
|
BADO, JEFFREY (DO)
1615 ASHBOURNE ROAD
ELKINS PARK, PA 19027
NPI-1801908173 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
BADO, JEFFREY (DO)
FDC PHILADELPHIA #71927-066, PO BOX 562
PHILADELPHIA, PA 19105
NPI-1801908173 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2017 |
|
BADUINI, JOLIE (RN)
1300 32ND AVE SW, APT 307
MINOT, ND 58701
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2015 |
|
BAER, MICHAEL L. (DC)
BAYSIDE STATE PRISON
LLESBURG, NJ 08327
NPI-1053654616 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2004 |
|
BAEZ, ANNA V. (DDS)
911 VILLAGE DRIVE
SOMERSET, NJ 08873
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/20/2002 |
|
BAFFOWAAH, ZIBORAH
4345 DIAMOND DRIVE
SAINT PAUL, MN 55122
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2015 |
|
BAGDASAROVA, ANGELICA (RN)
11981 AUDUBON AVENUE
PHILADELPHIA, PA 19116
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
BAH, HUSAINATU (RN/LPN)
2510 BIRCHWOOD COURT
NORTH BRUNSWICK, NJ 08902
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/15/2016 |
12/10/2019 |
BAH, HUSAINATU (RN/LPN)
2510 BIRCHWOOD COURT
NORTH BRUNSWICK, NJ 08902
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/28/2013 |
12/10/2019 |
BAHNSON, WILLIAM F. (MD)
28 HIGH STREET
TREENFIELD, MA 01301
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/2/1988 |
DECEASED |
BAILEY, FREDERICK (DDS)
41 WEST GLEN ROAD
DENVILLE, NJ 07834
NPI-1205048410 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/29/2016 |
|
BAINE, RICHARD M. (RN)
902 OCEAN ROAD
POINT PLEASANT BORO, NJ 08742
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/30/2024 |
Permanent |
BAIRD, DAVID B. (MD)
4107 MERCHANT SQ. PLACE
LANSDALE, PA 19446
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2004 |
|
BAJAKIAN, BRYAN (DC)
3105 STOWE LANE
MAHWAH, NJ 07430
NPI-1679618094 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/18/2010 |
|
BAJWA, LATIF AHMAD
PO BOX 633
LANGHORNE, PA 19047
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/9/2009 |
|
BAKER, INAISHA (CHHA)
3 FULLER PLACE, APT 11
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/27/2025 |
|
BAKER, MONIQUE (CHHA)
1521 NEWPORT STREET
CAMDEN, NJ 08104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/28/2019 |
|
BAKER, SCOTT (CNA)
215 BURLINGTON RD. SOUTH
BRIDGETON, NJ 08302
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/24/2002 |
|
BAKMAN, MILANA (CHHA)
4 IVY WAY
DAYTON, NJ 08810
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/19/2018 |
|
BALLERAS, ALFREDO B. (RPH)
1 VISTA DRIVE
MOUNT OLIVE, NJ 07836
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/14/2010 |
9/13/2013 |
BAMDAD, BABAK (RPH)
2 SOUTH GATE ROAD, APT 736
GREAT NECK, NY 11023
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/26/2011 |
5/25/2023 |
BAMDAD, BABAK (RPH)
333 RIVER STREET
HOBOKEN, NJ 07030
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
6/1/2010 |
5/25/2023 |
BAMGBOYE, PATRICK (DDS)
358 MEISEL AVENUE
SPRINGFIELD, NJ 07081
NPI-1720175508 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/7/2012 |
|
BANATTE, JEFF (RN)
50 NORTH EVERGREEN ROAD
EDISON, NJ 08837
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/29/2024 |
|
BANDY, ANHUAR
141 CRINE ROAD
COLTS NECK, NJ 07722
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/20/2018 |
|
BANDY, KARIM
141 CRINE ROAD
COLTS NECK, NJ 07722
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/20/2018 |
|
BANGOURA, ALPHA
200 EXECUTIE DRIVE
WEST ORANGE, NJ 07050
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/22/2006 |
|
BANKA, VIDYA (MD)
237 STACEY ROAD
PENN VALLEY , PA 19072
NPI-1588659965 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/19/2018 |
|
BANKOLE, ADEJOKE (CHHA)
986 18TH AVENUE, APT. 1
NEWARK, NJ 07106
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2023 |
|
GENE'S PHARMACY
640 PINE STREET
CAMDEN, NJ 08103BANKS, KENNETH
640 PINE STREET
CAMDEN, NJ 08103
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/14/2003 |
|
BAPTISTE, STANLEY (CHHA)
401 WEST VIRGINIA AVENUE, APT. B-16
NEPTUNE, NJ 07753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/19/2018 |
|
BARAHONA, RONY
549 SUMMIT AVENUE
MAPLEWOOD, NJ 07040
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/26/2013 |
|
BARAKAT, FATIMA (CHHA)
267 N 7TH STREET, FLOOR 1
PROSPECT PARK, NJ 07508
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/5/2023 |
|
BARAN-DICRISCIO, LORRAINE (CHHA)
309 IRIS ROAD
CHERRY HILL, NJ 08620
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/20/2002 |
|
BARAQUE, IVAN DARIO (MD)
4 WOODCREST COURT
WEST NYACK, NY 10994
NPI-1811059967 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2015 |
|
BARASCH, MILTON (RPH)
12 IVY WAY
ABERDEEN, NJ 07747
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/3/2000 |
Permanent |
BARATTI, CARMEN (DO)
150 KIRKBRIDGE ROAD
VOORHEES, NJ 08043
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/4/1997 |
|
BARBA, FIDELIS (MD)
2 POWDER HILL
SADDLE RIVER, NJ
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/11/2000 |
Permanent |
BARBER-HINSON, CONNIE
7011 SHADOW RUN
SAN ANTONIO, TX 78250
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
4/20/2011 |
|
BARBERS-WEBER, JENNIFER
8 ELKRIDGE PARKWAY
MANALAPAN, NJ 07726
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
11/5/2009 |
|
BARDEN, BRENDA (RN)
19 INTERVALE ROAD
SALEM, MA 01970
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/20/2012 |
|
BARDO, MANUEL
11756 SW 14TH TERRACE
MIAMI, FL
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/19/2004 |
|
BARET, MICHELLE (CHHA)
135 MARINA DRIVE
EDISON, NJ 06076
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
BARGE, NICHOLAS
716 NAUTILUS STREET
FORKED RIVER, NJ 08731
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/16/2011 |
|
BARGER, SHERRY (LPN)
187 KINGS HIGHWAY
MIDDLETOWN, NJ 07748
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/24/2022 |
|
BARI, ABDUL
264 PROSPECT STREET
NUTLEY, NJ 07110
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/19/2009 |
|
BARIEXCA, CARLA (LPN)
107 DAYTON STREET
TRENTON, NJ 08610
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2006 |
|
BARNA, ARLENE (RN)
205 KRAFT AVE.
OAKLYN, NJ 08107
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2003 |
|
BARNES, LIANNA C. (LPN)
4906 SCHINDLER TERRACE
BRIDGEWATER, NJ 08807
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/16/2023 |
|
BARNWELL, LATANYA
1048 PENNINGTON ROAD
EWING, NJ 08618
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
9/16/2011 |
9/17/2014 |
BARON, MICHAEL B. (MD)
SE 1256 BISHOP BLVD, STE1
PULMAN, WA 99163
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/11/2000 |
Permanent |
BARONE, THOMAS (DO)
255 17TH STREET
PHILADELPHIA, PA 19103
NPI-1780898965 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
BARROUS, FELIPE (EMT)
40 KNOLL TERRACE
HAZLET, NJ 07730
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/28/2015 |
|
BARSH, LAUREN AKA MCCABE, LAUREN (RN)
9 FIELDCREST WAY
HAZLET, NJ 07730
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/30/2019 |
|
BARTEK, MARY H. (DC)
3225 NAZARETH ROAD, APT 3943
EASTON, PA 18045
NPI-1427048701 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2023 |
|
BARTLOW, BRIAN
551 PARKWOOD AVENUE
TOMS RIVER, NJ 08753
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/17/2003 |
|
BAS, KONSTANTIN
2800 COYLE STREET #625
BROOKLYN, NY 11235
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/14/2018 |
8/6/2024 |
BASBUS, VICTOR M. (MD)
33 5TH AVENUE, APT 1B
NEW YORK, NY 10003
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/6/2009 |
Permanent |
BASCUS, NAOMI AKA DERRICK, NAOMI (RN)
6 ENGLISH IVY DRIVE
SICKLERVILLE, NJ 08081
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/9/2020 |
|
BASCUS, NAOMI AKA DERRICK, NAOMI (RN)
6 ENGLISH IVY DRIVE
SICKLERVILLE, NJ 08081
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/26/2016 |
|
BASKERVILLE, DEBORAH a.k.a. DUBLIN, DEBORAH (LPN)
130 GIULIA LANE
GALLOWAY, NJ 08205
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/19/2024 |
|
BASNETT, BETHANY (NP)
4940 PEPYS LN, APT 219
WILMINGTON, NC 28403
NPI-1487718938 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/15/2022 |
5/22/2024 |
BASSO, NICHOLAS V. (MD)
7665 MAPLE AVENUE
PENNSAUKEN, NJ 08109
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/1/2000 |
Permanent |
BATARSEH, BASEL (MD)
620 FAIRLAWN AVENUE
GLEN ROCK, NJ 07410
NPI-1063602696/1891803318 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/31/2017 |
|
BATARSEH, BASEL (MD)
85 VINCENT DRIVE
CLIFTON, NJ 07013
NPI-1063602696/1891803318 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2018 |
|
BATARSEH, BASEL (MD)
6-20 PLAZA ROAD
FAIR LAWN, NJ 07410
NPI-1891803318 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2018 |
|
BATEMAN, PAMELA (LPN)
91 CHESTNUT STREET
SALEM, NJ 08079
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/21/2008 |
|
BATES, NANCY M. (DO)
38 PALSA AVENUE
ELMWOOD PARK, NJ 07407
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/3/2001 |
Permanent |
BATISTA-ALCANTARA, YOKAURI (LPN)
286 COMSTOCK STREET
NEW BRUNSWICK, NJ 08901
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/27/2022 |
|
BATTISTI, RENATO PIETRO (DC)
6 MARLBORO ROAD
WESTBURY, NY 11590
NPI-1134392145 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/20/2023 |
|
BATTLE, TIFANY (CHHA)
393 IRVINE TURNER BOULEVARD, APT. 4D
NEWARK, NJ 07108
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
BAUBLITZ, CARRIE (RN)
80 CONEWAGO DRIVE
HANOVER, PA 17331
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2015 |
|
BAUCUM, JAMES (DO)
913 ELON LANE
EL PASO, TX 79912
NPI-1295239457 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/8/2025 |
Permanent |
BAUTISTA, FILOMENA (CHHA)
133 PAMRAPO AVENUE #1
JERSEY CITY, NJ 07305
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/14/2017 |
|
BAXTER, LOUIS E. (MD)
2 MANCHESTER COURT
COLUMBUS, NJ 08022
NPI-1962527051 |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/26/1983 |
4/2/2013 |
BAYOUMY, MAHETAB (CHHA)
47 BYRNE CT # B
WAYNE, NJ 07470
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2023 |
|
BEACHUM-THOMPSON, AMY (CHHA)
201 WEBSTER STREET
WOODBINE, NJ 08270
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/17/2018 |
8/20/2018 |
BEALS, PAUL V. (MD)
4120 WESTFIELD AVENUE
PENNSAUKEN, NJ 08110
NPI-1427175652 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/24/2014 |
|
BEASLEY, BRANDI (C N A)
433 ALFRED ROAD
TOMS RIVER, NJ 08757
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/11/2019 |
Permanent |
BEAUCEJOUR, MONIQUE (CHHA/CNA)
204 BERKELEY AVENUE, APT. 323
BLOOMFIELD, NJ 07003
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/29/2019 |
|
BECK, ALLAN G. (MD)
1833 ARROWHEAD DRIVE
WATERFORD, NJ 08089
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/20/2001 |
|
BECKETT, DONALD (DPM)
10144 DEERCLIFF DRIVE
TAMPA, FL 33647
NPI-1871692285 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/4/2005 |
|
BECKFORD, AUDREY L.
566 NORTH MAPLE AVENUE
EAST ORANGE, NJ 07017
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/20/2002 |
|
BEDRICK, BERNARD A.
300 EAST 56TH STREET
NEW YORK, NY 10022
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
BEECHER, GEORGE (MD)
137 EVERGREEN AVENUE
NW PROVIDENCE, NJ 07974
NPI-1073574059 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/8/2016 |
9/19/2018 |
BEECHER, GEORGE (MD)
137 EVERGREEN AVENUE
NW PROVIDENCE, NJ 07974
NPI-1073574059 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/19/2018 |
|
BEHRMAN, EDWARD (DO)
520 HAMBURG TURNPIKE
WAYNE, NJ 07470
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
BEIRNE, MARY F. (MD)
75 ABE VORHEES AVENUE
MANASQUAN, NJ 08736
NPI-1881782662 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2001 |
5/16/2011 |
BEIRNE, MICHELE
4410 RHONDA DRIVE
MILLVILLE, NJ 08332
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/25/2025 |
|
BEKHIT, CHRISTINA (RPH)
9 PEGGY ROAD
EAST BRUNSWICK, NJ 08816
NPI-1952616922 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/2/2022 |
5/1/2024 |
BEKHIT, CHRISTINA (RPH)
9 PEGGY ROAD
EAST BRUNSWICK, NJ 08816
NPI-1952616922 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/19/2024 |
Permanent |
BEKHIT, CHRISTINA (RPH)
9 PEGGY ROAD
EAST BRUNSWICK, NJ 08816
NPI-1952616922 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/19/2024 |
|
BEKIER, JACQUELYN (CHHA)
518 LAKE TERRACE
BRADLEY BEACH, NJ 07720
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
10/28/2022 |
BELIAEV, KIRA (CHHA)
108 36TH STREET
UNION CITY, NJ 07087
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
BELKHAOUDA, FATMA (CHHA)
277 HARRISON AVENUE, APT. D1
JERSEY CITY, NJ 07304
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/5/2023 |
|
BELKOFF, MEYER (DO)
29 ELMORA AVENUE
ELIZABETH, NJ 07202
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/17/1998 |
DECEASED |
BELL, BEANA
9926 HALDEMAN AVENUE
PHILADELPHIA, PA 19115
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
BELL, KIMBERLY (RN)
2030 HIGHWAY 35 N. UNIT K
ORTLEY BEACH, NJ 08735
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2001 |
2/7/2020 |
BELL, SHANNON (PHARM TECH)
6591 MILL ROAD
EGG HARBOR TOWNSHIP, NJ 08234
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/23/2017 |
|
BELLAMY, BERNICE
27 VILLAGE DRIVE
LUMBERTON, NJ 08060
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/20/2004 |
Permanent |
H & B TRANSP
401 SOUTH WHITEHORSE PIKE
MAGNOLIA, NJ 08049BELLAMY, HARVEY OWNER
CRAF PO BOX 7450
TRENTON, NJ 08625
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/20/2004 |
Permanent |
BELLO, REY N. (MD)
444 60TH STREET
WEST NEW YORK, NJ 07093
NPI-1780796409 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/31/2011 |
Permanent |
BELONY, IVELYSE (LPN)
131 PARK PLACE, APT. 1
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/28/2017 |
|
BELTER, MARK
20080 INDIAN HOLLOW ROAD
WELLINGTON, OH 44090
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/9/2024 |
|
BELTZER, BLAIR (MD)
2025 HAMBURG TURNPIKE
WAYNE, NJ 07470
NPI-1073635421 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/16/2015 |
11/22/2022 |
BENANTI, ELAINE
2840 WATERS EDGE CIRCLE
GREENACRES, FL 33413
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/18/2026 |
|
BENDER, TIFFANY (RN)
56 NOTRE DAME DRIVE
RIVERSIDE, NJ 08075
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/3/2022 |
|
BENHISSOUN, WIDAD (CHHA)
28 GROVE STREET, APT. 2D
PATERSON, NJ 07503
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/28/2024 |
|
BENKO, ALICIA #60674-050 (PHARM TECH)
FCI DANBURY RT 37
DANBURY, CT 06811
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/18/2009 |
|
BENNER, JOSHUA C. (CNA)
10 GLENWOOD ROAD
TOMS RIVER, NJ 08753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/15/2025 |
|
BENNETT, SHARON (CHHA)
736 EDGEWOOD AVENUE
TRENTON, NJ 08618
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
BENNETT-WILLIAMSON, KATHLEEN (LPN)
75 WALT WHITMAN WAY
TRENTON, NJ 08690
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/27/2001 |
Permanent |
BENSEMKY, AMINA (CHHA)
2828 KENNEDY BOULEVARD, APT. 361
JERSEY CITY, NJ 07306
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/26/2019 |
Permanent |
BENSIMHON, GEORGES (MD)
1488 SHELBOURNE COURT
ALLENTOWN, PA 18104
NPI-1649234394 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/16/2015 |
|
BENTLEY, BERNARD (MD)
715 BAYSHORE DRIVE, APT 406
FT LAUDERDALE, FL 33304
NPI-1992746044 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/15/2021 |
|
BENTLEY, CYNTHIA (RN)
220 GILPIN ROAD
WILLOW GROVE, PA 19090
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/15/2018 |
|
BENTON, DEBORAH AKA KING, DEBORAH (LPN)
9 RADFORD PLACE
WILLINGBORO, NJ 08046
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/18/2001 |
11/5/2018 |
BERGER, SHELDON H. (MD)
1032 ROUTE 34
MATAWAN, NJ 07747
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/30/2000 |
Permanent |
BERKELHAMMER, EDWARD (MD)
230 W. JERSEY ST.
ELIZABETH, NJ 07202
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/30/1990 |
Permanent |
BERKOWITZ, ANDREW (MD)
725 LISA CIRCLE, APT 11
HUNTINGDON VALLEY, PA 19006
NPI-1952454928 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2023 |
|
BERMAN, LARRY R. (DDS)
308 RARITAN DRIVE
HIGHLAND PARK, NJ 08904
NPI-1326191347 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/24/2010 |
|
BERMAN, LARRY R. (DDS)
308 RARITAN AVENUE
HIGHLAND PARK, NJ 08904
NPI-1326191347 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/20/2012 |
|
BERMUDEZ, RAFAEL Y. (CHHA)
7002 KENNEDY BLVD E., APT 331
GUTTENBERG, NJ 07093
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/30/2024 |
|
BERNSTEIN, IRA S. (DPM)
301 OLD TERRYTOWN ROAD
WHITE PLAINS, NY 10603
NPI-1629008271 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/1/2018 |
|
BERRY, BRADLEY D. (MD)
PO BOX 2008
GRUNDY, VA 24614
NPI- |
Medical
Industry Law Violation |
Disqualification Law and Public Safety
Consumer Affairs Board of Medical Examiners |
6/13/1991 |
DECEASED |
BESEN, LEE (MD)
325 OAKFORD ROAD
WAVERLY, PA 18471
NPI-1770559213 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/5/2024 |
|
BEST, ALEXANDER C.
P.O. BOX 7000
FORT DIX, NJ 08640
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/20/2005 |
|
BETHEA, ALFREDA (LPN)
1234 PROSPECT STREET
TRENTON, NJ 08638
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2002 |
|
BEUKAS, STEPHEN (DMD)
27 ROUTE 34 NORTH
COLTS NECK, NJ 07722
NPI-1275677213 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
3/30/2014 |
|
BEUKAS, STEPHEN (DMD)
MONMOUTH COUNTY CORRECTIONAL INSTITUTE, 1 WATERWORKS ROAD
FREEHOLD, NJ 07728
NPI-1275677213 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/18/2018 |
|
BEYNON SERFASS, LEONOR (RN)
18 WILSON AVENUE
CLARKS SUMMIT, PA 18411
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/30/2017 |
|
BEZOZA, HOWARD M. (MD)
PO BOX 372
SADDLE RIVER, NJ 07458
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/20/2003 |
|
BHANDARI, BHUPINDER (MD)
9550 SANTOS RANCH ROAD
PLEASANTON, CA 94588
NPI-1417068511 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/15/2023 |
|
BHATTI, HAMID
80 MILTON AVENUE, #1522
RAHWAY, NJ 07065
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2012 |
9/10/2019 |
BHATTI, SARFRAZ (RN)
413 S 6TH AVENUE
GALLOWAY, NJ 08205
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/13/2022 |
|
BIANCHI, CRYSTAL a/k/a CRYSTAL NEIGER GOULD (NP)
8125 DEVON STREET
PHILADELPHIA, PA 19118
NPI-1790999076 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/22/2025 |
|
BIENSTOCK, ALAN (MD)
171 DORCHESTER DRIVE
EAST WINDSOR, NJ 08520
NPI-1811900426 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/15/2024 |
|
BIENSTOCK, DOUGLAS (DO)
245 DIAMOND BRIDGE AVENUE
HAWTHORNE, NJ 07506
NPI-1831151356 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/16/2015 |
|
BIENSTOCK, DOUGLAS (DO)
245 DIAMOND BRIDGE AVENUE
HAWTHORNE, NJ 07506
NPI-1831151356 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/12/2016 |
|
BILENKIN, ELANA (MANAGER)
242 COMUNITY CIRCLE
OLD BRIDGE, NJ 08857
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/15/1998 |
Permanent |
BINDER, RANDY (RPH)
FCI PO BOX 1000
OTISVILLE, NY 10963
NPI-1972526572 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2015 |
Permanent |
BINDER, RANDY (RPH)
16 WINTER PLACE
ABERDEEN, NJ 07747
NPI-1972526572 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2016 |
Permanent |
BIONDELLO JR., PHILIP
41 CONCORD LANE
BASKING RIDGE, NJ 07920
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2017 |
|
BISHARA, GIRGIS (MD)
859 BRIGHTON PL.
OCEAN CITY, NJ 08226
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/17/1987 |
Permanent |
BITTNER, MELISSA C. (RN)
436 RIVER DRIVE
WESTVILLE, NJ 08093
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/19/2005 |
Permanent |
BLACKMAN, NOEL (MD)
MOSHANNON VALLEY CI, 555 GEO DRIVE
PHILIPSBURG, PA 16866
NPI-1720209521 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/30/2017 |
Permanent |
BLACKMAN, NOEL (MD)
MOSHANNON VALLEY CI, 555 GEO DRIVE
PHILIPSBURG, PA 16866
NPI-1720209521 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/26/2017 |
Permanent |
BLAIR, TONYA LAUR aka D'ANJOU, TANYA LAUR
624 FIG STREET
SCRANTON, PA 18505
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/2024 |
|
BLANCO, ALEX (DPM)
180 LAFAYETTE AVENUE, APT. 12A
PASSAIC, NJ 07055
NPI-1881677987 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/24/2017 |
|
BLANCO, LAZARO (PHARM TECH)
401 46TH STREET, APT. 5
UNION CITY, NJ 07087
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/28/2017 |
|
BLANTON, MALEEK (CHHA)
640 LINE STREET
CAMDEN, NJ 08103
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/14/2017 |
|
BLAU, SEYMOUR H. (DPM)
36 COLLEGE DRIVE
JERSEY CITY, NJ 07305
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/20/2003 |
|
BLEIMAN, MICHAEL (MD)
1100 ROUTE 72 WEST, SUITE 304
MANAHAWKIN, NJ 08050
NPI-1821086463 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/27/2017 |
4/27/2017 |
BLICK, JESSICA (APN)
2435 CROSSTOWN PARKWAY
BREMEN, GA 30110
NPI-1831511898 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/15/2022 |
|
BLOT, EDWARD (MD)
274 NORTH CENTER STREET
ORANGE, NJ 07050
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/5/2000 |
Permanent |
BLUM, NOEL
74 TWIN RIVERS DRIVE
EAST WINDSOR, NJ 08561
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
BLY, RODNEY
4737 FRANKFORD AVENUE, 3RD FLOOR
PHILADELPHIA, PA 19124
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
BLYN, CHARLOTTE (MD)
511 WINDING WAY
MERION , PA 19066
NPI-1669700910 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
BOADU, JACOB (RPH)
EUCLID TERRACE
PARSIPPANY, NJ 07054
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2007 |
|
BOAHENE, RICHARD SARFO (RPH)
110 TREETOPS DRIVE
LANCASTER, PA 17601
NPI-1093379521 / 1457782815 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/18/2024 |
|
BOAMAH, KWAKU (MD)
101 HAVEN WAY
MORGANVILLE, NJ 07751
NPI-1154413029 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/7/2017 |
8/2/2019 |
BOBADILLA, MARIA (CHHA)
85 PRESIDENTIAL BOULEVARD, APT. 2K
PATERSON, NJ 07522
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/5/2018 |
|
BOBADILLA, MARIA (CHHA)
85 PRESIDENTIAL BOULEVARD, APT. 2K
PATERSON, NJ 07522
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/5/2018 |
|
BOBRYSHEVA, SVETLANA (CHHA)
29 FOREST GARDEN DRIVE
MATAWAN, NJ 07747
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/26/2017 |
|
BODINE, DENISE (RN)
66 YORK STREET APT. 12
LAMBERTVILLE, NJ 08530
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/25/2011 |
|
BOEHM, GREGORY (MD)
26777 LORAIN AVENUE, SUITE 716
NORTH OLMSTEAD, OH 44070
NPI-1972678894 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
12/28/2021 |
BOGNER, EZRA
823 GRANGE ROAD
TEANECK, NJ 07666
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/29/2024 |
|
BOGNER, GAIL
481 HARRISON AVENUE
HIGHLAND PARK, NJ 08904
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/29/2024 |
|
BOGUSLAVSKIY, VADIM
1903 MADALINE DRIVE
AVENEL, NJ 07001
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/20/2001 |
|
A&B INVALID COACH, INC.
655 AMBOY AVENUE
WOODBRIDGE, NJ 07095BOGUSLAVSKIY, VADIM OWNER
1903 MADALINE DRIVE
AVENEL, NJ 07001
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/25/2002 |
Permanent |
BOHUSLAWSKY, NINA (RN)
P.O. BOX 4004
CLINTON, NJ 08809
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2010 |
|
BOISVERT, RAYMOND JOHN (RN)
2701 NW 23 BLVD, APT 225
GAINESVILLE, FL 32605
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2015 |
|
BOLARINWA, BOLAJI (APN/RN)
2 BUTTONWOOD COURT
MOORESTOWN, NJ 08057
NPI-1104476381 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/30/2024 |
|
BOND, CLIFTON (MD)
418 JAMESTOWN COURT
MT LAUREL, NJ 08054
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/21/1992 |
Permanent |
BONDAR, SOFIYA (DDS)
2815 COYLE ST. APT 210
BROOKLYN, NY 11235
NPI-1952355158 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/18/2011 |
|
BONETT, OLGA
5105 N. PARK DRIVE
PENNSAUKEN, NJ 08109
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
4/29/2003 |
|
BONILLA, CLEMY (CHHA)
2809 YORKSHIP ROAD
CAMDEN, NJ 08104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
BONITO, RODERICK J.
27 W. 1ST STREET, APT 205
BAYONNE, NJ 07002
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/19/2024 |
|
BONNELL, STEPHANIE (RN)
165 DEY GROVE RD
MONROE, NJ 08831
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/20/2002 |
|
BONSU, ACHIAA (CHHA)
1414 BIRCHWOOD COURT
NORTH BRUNSWICK, NJ 08902
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/14/2017 |
3/3/2020 |
BONSU, KWADWO (CHHA)
911 AZALEA DRIVE
NORTH BRUNSWICK, NJ 08902
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
BONSU, NANA (CHHA)
68 MYRTLE AVENUE
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/6/2018 |
|
BOODRAM, VERONA
134 EVERGREEN PLACE 8TH
EAST ORANGE, NJ 07018
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/22/2006 |
|
BOONE, LESLIE (RN)
122 SUMMIT AVENUE
TRENTON, NJ 08628
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2002 |
|
BORCHARDT, KAREN (RN)
4145 MILL CREEK DRIVE
N. CHARLESTON, SC 29420
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/17/2004 |
|
BORGES, JOHN MANUEL
550 BUCKINGHAM DRIVE
PISCATAWAY, NJ 08854
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2010 |
|
BORGES, JULISSA A.
77 W. 17TH STREET, APT 1
BAYONNE, NJ 07002
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2024 |
|
BORNHOLDT, HAE SUK (THERAPIST)
P. O. BOX 1288
MCAFEE, NJ
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2002 |
|
BORNSTEIN, KATHLEEN (LPN)
136 73RD STREET
NORTH BERGEN, NJ 07047
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/19/2004 |
|
BOROWEC, LAWRENCE W. (MD)
202 STATESBURG AVENUE
NEWFIELD, NJ 08344
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/18/1997 |
12/1/1998 |
BOROWEC, LAWRENCE W. (MD)
202 STOTESBURY AVENUE
NEWFIELD, NJ 08344
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
BORRELLI, HENRY (DPM)
49 PROSPECT STREET
LITTLE FALLS, NJ 07424
NPI-1902839830 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
4/6/2010 |
10/27/2017 |
BORTZ, AMANDA (PHARM TECH)
13 SWEET BRIAR DRIVE
SICKLERVILLE, NJ 08081
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/21/2016 |
4/5/2018 |
BOSTICK, MICHELLE (CHHA)
87 TILLINGHAST STREET
NEWARK, NJ 07108
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
BOTTENBLEY, CECIL J. (DMD)
16 FIRESIDE CT.
WILLINGBORO, NJ 08046
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/9/1987 |
Permanent |
BOUCHE, JASON
6641 E. MEADOWLARK LANE
PARADISE VALLEY, AZ 85253
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2012 |
|
BOULOS-PLUDOWSKI, GEORGEANN (RPH)
493 RINGWOOD AVENUE
PHILLIPSBURG, NJ 08865
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/19/2005 |
3/11/2013 |
BOWERS JR., THOMAS ROBERT
14 AMITY STREET
LITTLE FALLS, NJ 07424
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/20/2022 |
|
BOWICK, JUDY C. (CHHA)
1503 BOND STREET
ASBURY PARK, NJ 07712
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2002 |
|
BOYD, DARRYL
PO BOX 38, FCI
FORT DIX, NJ 08640
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/18/2002 |
|
BOYKIN, ASHLEE (CHHA)
602 HARBOR LANE
SICKLERVILLE, NJ 08081
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/6/2018 |
|
BOYKINS, TAMIKA (CHHA)
235 ABLETT VILLAGE
CAMDEN, NJ 08105
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/16/2018 |
|
BRABHAM, THEODORE J.
14 HAZARD STREET
ELIZABETH, NJ 07208
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/20/2001 |
Permanent |
BRACUTO, ANNMARIE (RN)
1319 ST. GEORGE AVENUE
RAHWAY, NJ 07065
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/12/2016 |
|
BRADLEY, EARL B. (MD)
1181 PADDOCK ROAD
SMYRNA, DE 19977
NPI-1669414553 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/20/2012 |
|
BRANCH, RHASHEEDAH D. (CHHA)
473 PARK AVENUE, APT #3
PATERSON, NJ 07504
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/11/2025 |
|
BRANCO, DOROTHY (LPN)
1012 W. GENEVA STREET
EGG HARBOR CITY, NJ 08215
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/11/2019 |
5/31/2022 |
BRANDT, DOUGLAS A.
5 HOWARD STREET
VERONA, NJ 07044
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2011 |
|
BRANDT, HERBERT L. (RPH)
6 DEVONSHIRE DRIVE
RANDOLPH, NJ 07689
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2011 |
|
BRANDT, JEFFREY M.
24 CRESTVIEW LANE
MOUNT ARLINGTON, NJ 07856
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/17/2011 |
|
BRAUNSTEIN, MOSES
2404 BRONX PARKWAY
BRONX, NY 10458
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
BRAVER, ALEXANDER (MD)
127 CROAK AVENUE
STATEN ISLAND, NY 10314
NPI-1811098650 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2007 |
|
BREEN, NICHOLAS (DMD)
7731 RUDDEROW AVENUE
PENNSAUKEN, NJ 08109
NPI-1730307836 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/18/1995 |
9/27/2013 |
BREEN, NICHOLAS (DMD)
7731 RUDDEROW AVENUE
PENNSAUKEN, NJ 08109
NPI-1730307836 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/14/1996 |
9/27/2013 |
BREEN, NICHOLAS (DMD)
926 HADDONFIELD ROAD
CHERRY HILL, NJ 08002
NPI-1730307836 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/6/2023 |
|
BREIHOF, PETER
51 COEYMAN AVENUE
NUTLEY, NJ 07110
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/5/2019 |
|
BRESLIN, KEVIN
847 GARDEN STREET, APT 1
HOBOKEN, NJ 07030
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
12/5/2025 |
|
BRESSMAN, DANIELLE (RN)
40 HARBORAGE AVENUE
BAYVILLE, NJ 08721
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/29/2019 |
|
BRETTLER, NORBERT AKA BRETTLER, NORMAN
401 COUNTRY CLUB DRIVE
CHERRY HILL, NJ 08003
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/12/2016 |
|
BREWINGTON, CYNTHIA (CHHA)
379 MILLBRIDGE ROAD
CLEMENTON, NJ 08021
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
BRICK, ROGER (MD)
31-33 WEST 11TH STREET
NEW YORK, NY 10026
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/15/2006 |
|
AMERICAN MEDICAL SVCS. PC
1 ALPHA AVENUE
VOORHEES, NJ 08043BRIGHAM, STEVEN C. (MD)
1 ALPHA AVENUE
VOORHEES, NJ 08043
NPI-1306012539 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/20/2018 |
|
BRINT, SAMUEL (DO)
515 BROADWAY
CAMDEN, NJ 08103
NPI-1538326780 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/15/1987 |
Permanent |
BRISTOL, KENNETH (RN)
PO BOX 931
FLAGSTAFF, AZ 06002
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/19/2006 |
|
BRITT, JANICE (RN)
28 SCHOOL STREET
SWANSEA, MA 02777
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/27/2019 |
|
BRIZER, DAVID ALLEN (MD)
6766 108TH STREET, APT A62
FOREST HILLS, NY 11375
NPI-1518181270 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2015 |
|
BRIZER, DAVID ALLEN (MD)
255 W 85TH STREET, APT 5B
NEW YORK, NY 10024
NPI-1518181270 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/30/2014 |
|
BROADNAX, DEITRICH
347 BELLEVILLE AV, #B8
BLOOMFIELD, NJ 07003
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/25/1998 |
Permanent |
BROCCOLI, CHRISTOPHER
126 CRESCENT AVENUE
DEPTFORD, NJ 08096
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
10/25/2023 |
|
BROCCOLI, CHRISTOPHER
P.O. BOX 1000
LEWISBURG, PA 17837
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2024 |
|
BRODSKY, KONSTANTIN (CHHA)
55 WEST 45TH STREET, FLOOR 7R
NEW YORK, NY 10036
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/2/2017 |
|
BROOKHIM, ROBEN (DDS)
120 LAWRENCE DRIVE
SHORT HILLS, NJ 07078
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2015 |
|
BROOKHIM, ROBEN (DDS)
444 MORRIS AVENUE
ELIZABETH, NJ 07208
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2000 |
|
BROOKMAN, HARVEY (MD)
301 OXFORD VALLEY ROAD
YARDLEY, PA
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/13/1995 |
|
BROOKS JR., OSCAR (COUNSELOR)
27 E VILLAGE OF STONEY RD
MAPLE SHAE, NJ 08052
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/17/1995 |
Permanent |
BROOKS, MAUREEN R. (LPN)
110 THIRD AVENUE
BELMAR, NJ 07719
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
10/9/2003 |
|
BROSIUS, ADAM
455 NE 5TH AVE., UNIT D434
DELRAY BEACH, FL 33483
NPI- |
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/4/2024 |
|
BROWN, ALEXANDRIA N. (RN)
803 DAWN LANE
WILLIAMSTOWN, NJ 08094
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/19/2005 |
|
BROWN, DANNY (CHHA)
527 CENTRE STREET
EASTON, PA 18042
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/6/2018 |
Permanent |
BROWN, DEANNA (CHHA)
611 B. BINGHAM STREET
NEPTUNE, NJ 07753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/23/2018 |
|
BROWN, DERVENT (CHHA)
151 FIRST STREET
ENGELWOOD, NJ 07631
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/26/2018 |
|
BROWN, IMAN (CHHA)
717 N. MICHIGAN AVENUE
ATLANTIC CITY, NJ 08401
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/14/2017 |
|
BROWN, JENNIFER-JUNE R. (CHHA)
347 CENTRAL PLACE
BELFORD, NJ 07718
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/13/2025 |
|
BROWN, KAYDIA (CHHA)
1033 SEWALL AVENUE
ASBURY PARK, NJ 07712
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
7/21/2025 |
BROWN, LAFONDA (CHHA)
485 EAST 19TH STREET, APT. #4-F
PATERSON, NJ 07524
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/26/2017 |
|
BROWN, LOUIS S (DC)
1082 MAURICE AVENUE
RAHWAY, NJ 07065
NPI-1780735787 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/2/2022 |
|
BROWN, ROGER H. (DMD)
601 ROUTE 206, UNIT 30
BELLE MEAD, NJ 08844
NPI-1457460305 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/27/2005 |
10/28/2022 |
BROWN, SAO (LPN)
9 ALAN STREET
WEST ORANGE, NJ 07052
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/5/2017 |
|
BROWN, TAJANAY (CHHA)
763 EAST 2ND STREET
PLAINFIELD, NJ 07062
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/19/2025 |
|
BROWN-COLEY, KELLI (LPN)
88 WEST 6TH STREET
BAYONNE, NJ 07002
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/11/2017 |
|
BRUNELLE, ELIZABETH (LPN)
5902 EAST 2ND STREET
TUCSON, AZ 85711
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/19/2006 |
|
BRUNO, MARK
18 RIDGEWOOD COURT
NORTHFIELD, NJ 08225
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/11/2023 |
|
BRYANT-DERRICK, KISHARA (LPN)
107 DEAL AVENUE
NEPTUNE, NJ 07753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/12/2016 |
|
BUCHMANN, LISA M. a.k.a. HEUMAN, LISA M. (LPN)
6618 REEGA AVENUE
EGG HARBOR TOWNSHIP, NJ 08234
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/19/2024 |
|
BUCKLEY, MARIANNE (LPN)
83 IRVING COURT
TRENTON, NJ 08610
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2001 |
|
BUFANIO, NICHOLAS A (DC)
1530 GREYSTONE PLACE
HELLERTOWN, PA 18055
NPI-1336195825 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2022 |
|
BUFANIO, NICHOLAS A (DC)
1530 GREYSTONE PLACE
HELLERTOWN , PA 18055
NPI-1336195825 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2022 |
|
BUITRAGO, CARMEN (LPN)
412 CLIFF STREET, APT. 1
FAIRVIEW, NJ 07022
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/12/2018 |
|
BULGER, PATRICE (RN)
117 MILL CREEK ROAD
BAYVILLE, NJ 08721
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/15/2002 |
|
BULLARD, ANGELA (CHHA)
268 E. 21ST STREET, 3RD FLOOR
PATERSON, NJ 07513
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/26/2017 |
|
BUNCH, LATITIA (LPN)
212 S. 27TH STREET
CAMDEN, NJ 08105
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/20/2002 |
|
BUNN, YAHMINAH (CHHA)
22 GATLING COURT
NEW BRUNSWICK, NJ 08901
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2017 |
|
BUONO, DONNA (RN)
61 S. LOCUST AVE
MARLTON, NJ 08053
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2003 |
|
BURDETTE, KAYLA F. (CHHA)
31 ISLAND AVENUE
SEASIDE PARK, NJ 08752
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/14/2014 |
|
BURDUCEA, ALEXANDRU (DO)
223 SHOREWARD DRIVE
GREAT NECK, NY 11021
NPI-1558540807 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/15/2022 |
|
BURGOS, LEALYNN (CHHA)
636 BILLINGS AVENUE
PAULSBORO, NJ 08066
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
BURKARD, JUDITH (LPN)
320 7TH AVENUE APT 16
ASBURY PARK, NJ 07712
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/23/2009 |
11/23/2010 |
BURKE, WILLIAM (MD)
PO BOX 670
NEW VERNON, NJ 07976
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/20/2006 |
|
BURKES, JEFFREY (DDS)
176 LAKEWOOD AVENUE
HO-HO-KUS, NJ 07423
NPI-1073690137 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/19/2009 |
|
BURKETT, EILEEN (PHARM TECH)
1407 VIRGINIA COURT
MARLTON, NJ 08053
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
4/20/2011 |
|
BURNETT, RASHEEDAH (CHHA)
860 SOUTH 11TH STREET, APT. 4-B
NEWARK, NJ 07108
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
BURNS, MARGARET
2429 WESTFIELD AVENUE
SCOTCH PLAINS, NJ 07076
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2003 |
|
BURRELL, TIARA (CHHA)
141 STRANGER AVENUE
GLASSBORO, NJ 08028
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2019 |
|
BURRIS, WILLIAM G. III
2055 SHERIDAN ROAD
ENCINITAS, CA 92024
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/5/2025 |
|
BURRIS, WILLIAM G. JR.
744 JEFFREY ROAD
MOORESTOWN, NJ 08057
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/5/2025 |
|
BURSZTYN, ESTHER
5 BROOK ROAD
HOWELL, NJ 07731
NPI-1740605542 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/9/2024 |
1/13/2025 |
BURTON, FREDERICK (MD)
1455 CITY AVENUE
WYNNEWOOD, PA 19096
NPI-1811932874 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/15/2021 |
|
BURWELL-ADENIJI, LORIN (CHHA)
1004 HIGH STREET
BURLINGTON, NJ 08016
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
BUSSEY, PAUL (MD)
187 KIRSCHLING DRIVE
SWEDESBORO, NJ 08095
NPI-1356341424 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/22/2016 |
|
BUSSEY, PAUL (MD)
1 MILL STREET
WOODSTOWN, NJ 08098
NPI-1356341424 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/13/2015 |
|
BUTT, ATIQ (PRESIDENT)
2524 FORD ROAD
BRISTOL, PA 19007
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/15/2001 |
Permanent |
BUTTERHOF, TRACY (RN)
501 S. BERLIN AVE.
EGG HARBOR CITY, NJ 08215
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/20/2003 |
|
BUTTERWORTH, ELIZABETH A. (APN/RN)
10 BOBWHITE LANE
CAPE MAY COURT HOUSE, NJ 08210
NPI-1497863468 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/22/2025 |
|
BUTTS, YOLANDA (CNA)
600 PACIFIC AVENUE, APT. A102
ATLANTIC CITY, NJ 08401
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/2/2020 |
|
BYADGI, CHETHAN (MD)
LACKAWANNA COUNTY PRISON, 1371 NORTH WASHINGTON AVENUE
SCRANTON, PA 18509
NPI-1063537215 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2017 |
|
BYAHATTI, PRAMILA (MD)
200 EXCHANGE STREET, UNIT 217
PROVIDENCE, RI 02903
NPI-1841212800 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/23/2020 |
|
R & B MEDICAL TRANSPORTATION
844 JEROME AVENUE
HILLSIDE, NJ 07205-3108BYERS, FAYE AKA BYERS, RAYMOND
844 JEROME AVENUE
HILLSIDE , NJ 07205
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/14/2005 |
|
BYRNE, RACHEL (LPN)
6 STOWE DRIVE
SHAMONG, NJ 08088
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/5/2023 |
3/25/2026 |
BYRON, PETER J.
128 E. MORNING GLORY ROAD, APT 1
WILDWOOD, NJ 08260
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/15/2025 |
|
CABALEIRO, YODALIO (MD)
3700 KENNEDY BLVD.
UNION CITY, NJ 07087
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/18/1986 |
Permanent |
CABALERIO, THERESA
4611 BERGENLINE AVE.
UNION CITY, NJ 07087
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
CABAN, DESTINY (CHHA)
105 BOYD STREET
CAMDEN, NJ 08105
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
12/23/2024 |
CABATIC, VIRGINIA C. (RN)
14 SPARROW ROAD
RANDOLPH, NJ 07869
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/19/2005 |
|
CABRERA, RAMON BRETON
486 ZAMBORY STREET, APT.
PERTH AMBOY, NJ 08861
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
9/19/2011 |
|
CACERES, MARIO
328 MARKET STREET
CAMDEN, NJ 08102
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/1998 |
|
NEW HOPES OF NJ, INC.
328 MARKET STREET
CAMDEN, NJ 08102CACERES, MARIO ( CO-OWNER)
328 MARKET STREET
CAMDEN, NJ 08102
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/5/2000 |
|
CACI, FRANCIS R. (DDS)
248 SOUTH SUMMIT AVENUE
HACKENSACK, NJ 07601
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/8/1997 |
DECEASED |
CACOILO, MARIA (OFF. MGR.)
1150 AMBOY AVENUE
EDISON, NJ 08837
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/29/2003 |
|
CAESAR, MICHELLE BRIDGET (LPN)
289 TREMONT AVENUE, APT 1
EAST ORANGE, NJ 07018
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/30/2025 |
|
CAI, PING (DMD)
22 SAGE STREET
HOLMDEL, NJ 07733
NPI-1275667362 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/10/2012 |
9/15/2017 |
CALABRESE, ANGELO (MD)
FCI-SCHUYLKILL, PO BOX 759
MINERSVILLE, PA 17954
NPI-1891722237 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/22/2016 |
|
CALABRESE, ANTHONY (RN)
105 JOAN COURT
JACKSON, NJ 08527
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/22/2020 |
|
CALDERON, TANISHA (CHHA)
108 N. 16TH
EAST ORANGE, NJ
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/20/2002 |
|
CALLAHAN, VICTORIA (PHARM TECH)
130 FROST AVENUE
PHILLIPSBURG, NJ 08865
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/21/2017 |
Permanent |
CALVANICO, ROSA
47 SVEA AVENUE
CLIFTON, NJ 07013
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/28/2024 |
|
CALVELO, ARSENIO C. (RN)
13515 SCENIC GLADE DR.
HOUSTON , TX 77059
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/19/2003 |
|
CAMACHO, OLGA (CHHA)
176 KNAPP AVENUE
CLIFTON, NJ 07011
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/17/2018 |
|
CAMARDA, PAUL
10470 SW 6TH STREET
MIAMI, FL 33174
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/14/2024 |
|
CAMELOTTO, JULIE a/k/a JULIE DISKINT (PT)
44 MILLER ROAD
MORRISTOWN, NJ 07960
NPI-1093294555 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2025 |
|
CAMP, SUZANNE (RN)
P.O. BOX 423
PORT ELIZABETH, NJ 08348
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/21/2010 |
|
CAMPANELLA,-KAPLAN, DONNA (LPN)
1355 W. POINT AVENUE
MAYS LANDING, NJ 08330
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/10/2018 |
|
CAMPBELL JR., HIGHLAND (MD)
1009 MEADOWVIEW LANE
MONT CLARE, PA 19453
NPI-1043270143 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
12/18/2020 |
CAMPBELL, MELESIA S. (RN)
586 BLOOMFIELD AVENUE
CLIFTON, NJ 07012
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/17/2024 |
|
CAMPBELL, MELESIA S. (LPN)
586 BLOOMFIELD AVENUE
CLIFTON, NJ 07012
NPI-1144871088 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2024 |
|
CAMPBELL, SONIA S. (CHHA)
110 WILLIAMS AVENUE, APT 1L
JERSEY CITY, NJ 07304
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/27/2024 |
|
CAMPIONE JR., FRANK (PA)
431 STONEY POINT ROAD
BRICK, NJ 08733
NPI-1598856924 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/16/2016 |
2/19/2020 |
CANALES JR., DELOVI
11 ALBERT STREET
TOMS RIVER, NJ 08953
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/30/2010 |
4/30/2013 |
CANARES, ALEXANDER (RN)
60 RBOOKSIDE AVENUE, APT. 2-B
SOMERVILLE, NJ 08876
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2018 |
|
CANE, LAMONT (NURSES AIDE)
P.O. BOX 90431
CAMDEN, NJ 08012
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
8/18/1997 |
|
CANNON, JEROME
4221 NORTH 6TH STREET
PHILADELPHIA, PA 19140
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2015 |
|
CANTAVE, MARIE (CHHA)
1217 OCEAN AVENUE, APT. C-12
BRADLEY BEACH, NJ 07720
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/18/2017 |
|
CANTERMEN, LYNN (RN)
518 N. HILDEBRAND AVENUE
GLENDORA, NJ 08029
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2018 |
|
CAPACIO, RICHARD (DC)
99 ANNAPOLIS DRIVE
SICKLERVILLE, NJ 08081
NPI-1245230929 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/20/2006 |
|
CAPILLI, MICHAEL A. (DC)
427 HOYT STREET
LONG BRANCH, NJ 07740
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/9/2001 |
|
CAPITANO, PETER (RPH)
SCHUYLKILL FCI, PO BOX 759
MINERSVILLE, PA 17954
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
CAPO, LASARAH (CHHA)
50-52 ROSA PARK BOULEVARD, APT. 5
PATERSON, NJ 07501
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
CAPOBIANCO, LEO J. (DO)
7 CASTLE COURT
RANDOLPH, NJ 07860
NPI-1063483097 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/5/2002 |
6/8/2018 |
CAPPADONA, CHARLES (MD)
186 CORBIN COURT
LAKEWOOD, NJ 08701
NPI-1326054248 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/15/2025 |
|
CAPPIELLO, RAFAEL (MD)
2704 BRIENZA WAY
LAS VEGAS, NV 89117
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/19/1999 |
Permanent |
CAPRIOLA, EDWARD (MD)
313 S. FRANK ROGERS
HARRISON, NJ 07029
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/20/2006 |
DECEASED |
CARABALLO, CARLA (CHHA)
742 EAST SEVENTH STREET
PLAINFIELD, NJ 07062
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/13/2017 |
Permanent |
CARAGINE JR., PAUL J. (MD)
1 SAWMILL ROAD
KINNELON, NJ 07504
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/18/2001 |
Permanent |
CARCHIA, ETTORE (DC)
994 SANDY CIRCLE
MANAHAWKIN, NJ 08050
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/20/2006 |
|
CARDENAS, PRESENTACION E. (RN/LPN)
274 BATH AVE., #22
LONG BRANCH, NJ 07740
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2001 |
|
CARDILLO, JOHN
162 GARFIELD STREET
BERKELEY HEIGHT, NJ 07922
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/20/2006 |
|
CARDILLO, JOHN
162 GARFIELD STEET
BERKELEY HEIGHT, NJ 07922
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/4/2005 |
|
CARDILLO, RICHARD C. (MD)
2893 BIRCH ROAD
SUAMICO, WI 54173
NPI-1477520807 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/27/2002 |
8/30/2023 |
CARDINAL, PETER (MD)
520 WALNUT STREET, APT. 3
LEMOYNE, PA 17043
NPI-1104985142 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
CARDOSO SR., LUCIO (MD)
FCI FORT DIX
FORT DIX, NJ 08640
NPI-1639119019 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/3/2014 |
|
CARDOSO SR., LUCIO (MD)
253 LAFAYETTE STREET
NEWARK, NJ 07105
NPI-1639119019 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
2/22/2012 |
|
CAREY JR., CHARLES B.
218 BRIANT PARK DRIVE
SPRINGFIELD, NJ 07081
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2015 |
|
CARIDAD, MICHELLE (CHHA)
10 BROOKSIDE COURT
TOMS RIVER, NJ 08753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
CARIDEO, IDA (MD)
7 MALKE DRIVE
WAYSIDE, NJ 07712
NPI-1578842977 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/7/1999 |
8/1/2012 |
CARINO, JOVY
37 JAMES STREET
BLOOMFIELD, NJ 07003
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/29/2009 |
|
CARLSON, LILLIAN MAE (RN)
275 HIGH STREET APT. Q334
GLASSBORO, NJ 08028
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/18/2009 |
|
CARLUCCI JR., WILLIAM A (RPH)
FCI FORT DIX
FORT DIX, NJ 08640
NPI-1902120363 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
9/25/2014 |
|
CARLUCCI, ROBERT A. (RPH)
PO BOX 759
MINERSVILLE, PA 17954
NPI-1639493091 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
9/25/2014 |
Permanent |
CARMENATY, ANTHONY (LPN)
28 SUMMER STREET
PASSAIC, NJ 07055
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/25/2019 |
|
CARMONA, ALICE Y.
78 DAWN STREET
VINELAND, NJ 08302
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/23/2000 |
Permanent |
CARR, JOEL R. (DO)
8 JASMINE ROAD
LUMBERTON, NJ 08048
NPI-1275586489 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/2/2011 |
|
CARR, PATRICIA
P.O. BOX 91
BROWNS MILLS, NJ 08015
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2001 |
|
CARRION, NANCY (CHHA)
76 ZABRISKIE STREET
JERSEY CITY, NJ 07307
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/5/2018 |
|
CARRION, SARAH (CHHA)
1086 KENYON AVENUE
PLAINFIELD, NJ 07060
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/9/2018 |
|
CARROLL, KIMBERLY J. (LPN)
18 LEE AVENUE
HADDOMFIELD, NJ 08033
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/18/2011 |
|
CARSON, YOLANDA (CHHA)
65 DALES AVENUE, APT. 1137
JERSEY CITY, NJ 07306
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
CARTER, DARRICKA C. (DPM)
2505 ST. REGIS DRIVE
RICHMOND, VA 23236
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2010 |
|
CARUSO, EDMUND M. (DMD)
2275 KENNEDY BLVD.
JERSEY CITY, NJ 07304
NPI-1811132442 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/10/1994 |
Permanent |
CARUTHERS, SAMUEL (MD)
104 BRIARCLIFF ROAD
MOUNTAIN LAKES, NJ 07046
NPI-1225034887 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/15/2025 |
|
CASAS, JOSE (MD)
215 PASSAIC AVENUE
PASSAIC, NJ 07055
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/24/1999 |
Permanent |
CASAVINA, PHILIP
244 KNOX AVENUE
CLIFFSIDE PARK, NJ 07650
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
CASCIO, DANIEL (RN)
17 SEGUR STREET
DOVER, NJ 07801
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2002 |
|
CASSELL, BINDU
830 CALLOWHILL ROAD
PERKASIE, PA 18944
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
12/14/2022 |
|
CASSELL, DANIEL
830 CALLOWHILL ROAD
PERKASIE, PA 18944
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
12/14/2022 |
|
CASSIDY, BROOKE E. (RN)
1 SURREY LANE
OCEAN, NJ 07712
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/16/2026 |
|
CASTANEDA, JOSE (APN)
194 E. 7TH STREET
CLIFTON, NJ 07011
NPI-1699840264 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/26/2015 |
2/16/2022 |
CASTANEDA, JOSE (APN)
1925 PACIFIC AVENUE
ATLANTIC CITY, NJ 08401
NPI-1699840264 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
2/22/2012 |
2/16/2022 |
CASTANON, ROBERTO
555 GEO DRIVE
PHILLIPSBURG, PA 16866
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/16/2011 |
|
PASSAIC FAMILY MEDICAL
540 BROADWAY
PASSAIC, NJ 07055CASTELLANO, DOLORES (OWNER)
4300 SW 57TH STREET
MIAMI, FL 33155
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/17/2004 |
Permanent |
CASTILLO, AL JEHDD (CHHA)
170 32ND STREET WEST
BAYONNE, NJ 07002
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/28/2018 |
|
CASTILLO, HECTOR L. (MD)
1000 MADISON AVENUE
PATERSON, NJ 07501
NPI-1528198124 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
2/19/2012 |
|
CASTILLO, STEVEN A. (DDS)
P.O. BOX 16421
JERSEY CITY, NJ 07306
NPI-1134342017 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/5/1997 |
Permanent |
CASTRO, FRANKLIN CHACHO (RN)
41 MIDDLE AVENUE
SUMMIT, NJ 07901
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2023 |
|
CATANIA, RAYMOND (DO)
5 BRIARWOOD DRIVE EAST
WARREN, NJ 07059
NPI-1023094711 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/16/2021 |
|
CATANIA, RAYMOND J. (DO)
5 BRIARWOOD DRIVE E.
WARREN, NJ 07059
NPI-1023094711 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/20/2023 |
|
CATANZARO, DANIEL (DC)
28 ETOWAH RIDGE DRIVE, SW
CARTERSVILLE, GA 30120
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/20/2005 |
|
CATANZARO, VINCENT F. (MD)
560 MAIN STREET
ALLENHURST, NJ 07711
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
DECEASED |
CATHERS, THOMAS (LPN)
707 BURLINGTON AVENUE
DELANCO, NJ 08075
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/6/2019 |
|
CAVALLARO, KEVIN (RN)
630 SALEM AVENUE
FRANKLINVILLE, NJ 08322
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/11/2019 |
Permanent |
CAVALLI, DEAN
762 BROADWAY
CAMDEN, NJ 08103
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
CAVE, SANDY
109 BOBWHITE ROAD
ROYAL PALM BEACH, FL 33411
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2012 |
|
CECE, ANGELO (DMD)
566 NYE AVENUE
IRVINGTON, NJ 07111
NPI-1033396593 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/19/1996 |
Permanent |
CEDENO, HUMBERTO (RPH)
601 ELIZABETH AVENUE
ELIZABETH, NJ 07206
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/3/1984 |
Permanent |
CENTENO, JOSEPH (LPN)
9 SURBURBIA COURT
JERSEY CITY, NJ 07305
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/5/2017 |
Permanent |
CENTRELLI, MARC (DC)
176 ALPINE TRAIL
SPARTA, NJ 07871
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/21/2008 |
|
CHA, DONG S. (MD)
608 S. BROAD STREET
WOODBURY, NJ 08096
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
CHACK, JOEL (DO)
5 GWEN COURT
CHERRY HILL, NJ 08003
NPI-1093739096 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/13/2011 |
1/6/2012 |
CHACKER, JASON
104 FREEDOM WAY
SICKLERVILLE, NJ 08638
NPI-1609058916 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2024 |
|
CHACKER, JASON (PA)
1030 DOMINO LANE
WARMINSTER, PA 18974
NPI-1609058916 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/10/2020 |
|
CHAI, CHRISTINA (RPH)
2561 LEIGHTON STREET
FORT LEE, NJ 07024
NPI-1689997835 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/24/2016 |
|
CHAIKEN, BARBARA (LCSW)
419 OTISCO DRIVE
WESTFIELD, NJ 07090
NPI-1871768465 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
RADIATION ONCOLOGY GROUP
100 FORD ROAD
DENVILLE, NJ 07107CHAM, WILLIAM C. (MD)
11 HICKORY DRIVE
CHESTER TWP, NJ 07930
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/29/1997 |
|
CHAMBERS, CAROL (CHHA)
1022 STUYVESANT AVENUE
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/20/2004 |
|
CHAMPAGNE, CIARA C. (RN)
3106 TREMLEY POINT ROAD
LINDEN , NJ 07036
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/8/2024 |
|
CHAMPION, MARY M. (RN)
91 SOUTH MT AIRY AVE
EGG HARBOR TOWNSHIP, NJ 08234
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/3/2022 |
|
CHAMPION, MARY MARGARET (RN/CHHA)
91 MOUNT AIRY AVE., SOUTH
EGG HARBOR, NJ 08234
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2005 |
6/11/2013 |
CHANDLER, BRYAN K.
10 ELLINGTON STREET #1
EAST ORANGE, NJ 07017
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/28/2008 |
|
CHANDLER, CHARLES
219 N. WALNUT STREET, FL. 1
EAST ORANGE, NJ 07017
NPI-1417996901 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/4/2009 |
|
CHANSKY, CHRISTINE (MD)
820 NORTH AVENUE
WESTFIELD, NJ 07090
NPI-1508125600 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/2018 |
|
CHAPLAN, ABRAHAM (MD)
384 NORTH WOODLAND ST.
ENGLEWOOD, NJ 07631
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
CHARLES, ESTHER (CHHA)
380 UNION AVENUE
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/6/2018 |
|
CHATMON, ALTON (RPH)
RR8, BOX 370
BRIDGETON, NJ 08302
NPI-1790091742 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/3/2017 |
|
CHAUDHRY, YASMIN (OWNER)
333 NORTH BROAD STREET
ELIZABETH, NJ 07028
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/21/1997 |
|
CHAVEZ, REYNA A. (CHHA)
846 E. 27TH STREET
PATERSON, NJ 07513
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/4/2025 |
|
CHEESE, EPHONIA (CHHA)
18 PATRIOT LANE
WILLINGBORO, NJ 08046
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/16/2018 |
|
CHEN, BONNIE (MD)
243 HORSENECK ROAD
FAIRFIELD, NJ 07004
NPI-1750373486 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/12/2018 |
Permanent |
CHEN, KENNETH (MD)
244 BROADWAY
NEWARK, NJ 07104
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/7/1999 |
|
CHEN, TAN (MD)
12 LORRAINE DRIVE
PINE BROOK, NJ 07058
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/5/1999 |
Permanent |
CHERVIN, ARON
36 LAKE DRIVE
NORTH BRUNSWICK, NJ 08902
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/11/2016 |
|
CHESS, JEFFREY S. (MD)
1570 OLD CEDAR SWAMP ROAD
GLEN HEAD, NY 11545
NPI-1073511929 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/26/2023 |
Permanent |
CHESS, JEFFREY S. (MD)
1570 OLD CEDAR SWAMP ROAD
GLEN HEAD, NY 11545
NPI-1073511929 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2024 |
|
CHESTON, EBONY (CHHA)
33 NEWELL AVENUE
TRENTON, NJ 08618
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/6/2018 |
|
CHHADEH, AHED
401 NEW BRUNSWICK AVENUE, APT. 221
EAST BRUNSWICK, NJ 08816
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/21/2016 |
|
CHIAPETTA, THERESA
8 STEINHARDT AVENUE
OLD BRIDGE, NJ 08857
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/15/2008 |
|
CHIAPETTA, THERESA
8 STEINHARDT AVENUE
OLD BRIDGE, NJ 08857
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/12/2009 |
|
CHICCO, LUKE #65503-050
FCI FAIRTON, PO BOX 420
FAIRTON, NJ 08320
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/5/2019 |
|
CHIKOWSKI, JOHN (RN)
121 WEST 29TH STREET, 2ND FLOOR
BAYONNE, NJ 07002
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/24/2018 |
4/9/2019 |
CHILLEMI, SALVATORE
29 BERKSHIRE DRIVE
SEWELL, NJ 08080
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/10/2011 |
|
CHIRUMAMILLA, RAMABU (RPH)
212 E PITTSBURGH AVENUE
WILDWOOD CREST, NJ 08260
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/11/1985 |
Permanent |
CHIZHOV, ELLA
200 WINSTON DRIVE #C1104
CLIFFSIDE PARK, NJ 07010
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/21/2008 |
|
CHIZHOV, SERGEY
200 WINSTON DRIVE
CLIFFSIDE PARK, NJ 07010
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2007 |
|
CHLOROS, STACY (LPN)
323 GILL LANE
ISELIN, NJ 08830
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/18/2006 |
|
CHOI, JEHEE (RN)
31 PINE RIDGE LANE
MANSFIELD CENTER, CT 06250
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/27/2018 |
|
CHOI, STANLEY S. aka CHOI, STAN S. (MD)
12 ANTHONY AVENUE
EDISON, NJ 08820
NPI-1053337253 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/5/2023 |
Permanent |
CHRISTENSEN, CYNTHIA (RN)
20 SKYLINE DRIVE
HAZLET, NJ 07730
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/18/2001 |
|
CHRISTJOHN, COLLEEN M. (LPN)
144 CORSON TAVERN ROAD
SOUTH SEAVILLE, NJ 08246
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/11/2007 |
Permanent |
CHRISTMAS, ARTHUR
66 NORTH 11TH STREET
NEWARK, NJ 07107
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/16/2006 |
Permanent |
CHRISTPHONTE, CAIRY (CHHA)
1976 OSTWOOD TERRACE
UNION, NJ 07083
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/9/2019 |
Permanent |
CHU, ALICE (MD)
1512 PALISADE AVENUE, APT. 6P
FORT LEE, NJ 07024
NPI-1356505127/1962513366 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/24/2019 |
|
CHUDRY, RAZA
RD #5 FEDERAL PRISON
LEWISBURG, PA 17837
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2002 |
|
CHUGH, JAGDISH (MD)
1 CORINE COURT
LONG VALLEY, NJ 07853
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/2/2019 |
|
CHUKWUANI, ROSETTA (CHHA)
3 LISZKA LANE
SAYREVILLE, NJ 08872
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/28/2009 |
|
CHUKWUMBA, PEACE CHINEDU (LPN)
273 NORWAY AVENUE
TRENTON, NJ 08609
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/21/2024 |
|
CHULAK, GENADY (PRESIDENT)
242 COMMUNIT CIRCLE
OLD BRIDGE, NJ 08857
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/15/1996 |
Permanent |
CHUN, KYE (DO)
53 MEADOWBROOK ROAD
SHORT HILLS, NJ 07078
NPI-1356371819 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/31/2022 |
|
CHUNMUANG, PRASERT (MD)
401 DEVONSHIRE PL
FRANKLIN LAKES, NJ 07417
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/14/1993 |
Permanent |
CHUPREVICH, EILEEN, D. (RN)
8 STANTON PLACE
BUTLER, NJ 07405
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/20/2003 |
|
CIALLELLA, GINA AKA GARCEN, GINA (DC)
57 GREEN STREET
WOODBRIDGE, NJ 07095
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/24/2000 |
Permanent |
CICCONE, GREGORY
5 WATERS EDGE DR.
LITTLE EGG HARB, NJ 08087
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/15/2005 |
|
CICERO, BARBARA (RN)
91 LINCOLN AVENUE
SOMERVILLE, NJ 08876
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2001 |
|
CICERO, RALPH (DDS)
245 BALDWIN STREET
SUCCASUNNA, NJ 07876
NPI-1740449305 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
3/6/2014 |
|
CICERON, ANDRE (MD)
621 BANNING AVENUE
NORTHFIELD, NJ 08225
NPI-1265526586 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2019 |
Permanent |
CLACKLEY, MACK O. (LPN)
PO BOX 150
DELMONT, NJ 08314
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2001 |
|
CLAPPER, STEPHANIE (LPN)
169 NAUTILUS
MANAHAWKIN, NJ 08050
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/26/2010 |
|
CLARK, JAMES
380 MOUNTAIN ROAD #12
UNION CITY, NJ 07087
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/27/2007 |
|
CLARK, ALLAN (MD)
1200 VILLAGE DRIVE, APT 2413
PITTSBURGH, PA 15241
NPI-1033260120 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/15/2021 |
|
CLARK, INDIA (CHHA)
55 SECOND AVENUE
TOMS RIVER, NJ 08757
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/14/2017 |
5/6/2021 |
CLARK, JOVONNE (CHHA)
1605 SEWALL AVENUE
ASBURY PARK, NJ 07712
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/22/2017 |
|
CLARK, KEVIN
537 TRINITY PLACE
WESTFIELD, NJ 07090
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
10/5/2009 |
|
CLARK, NORMAN L. (MD)
5 TARA DRIVE
PARSIPPANY, NJ 07054
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/2/1999 |
|
CLARK, RAYONNE
844 CENTRE STREET
TRENTON, NJ 08611
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/13/2003 |
|
CLARK, RAYONNE
844 CENTRE STREET
TRENTON, NJ 08611
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/20/2003 |
|
CLARK. NYKEBA (CHHA)
807 N. INDIANA AVENUE
ATLANTIC CITY, NJ 08401
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/24/2018 |
|
CLARKE, KIRK (CHHA)
218 YOUNGS ROAD
TRENTON, NJ 08619
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/30/2019 |
Permanent |
CLARKE, MICHELLE (CHHA)
75 NORTH WALNUT STREET, APT. 6C
EAST ORANGE, NJ 07017
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/30/2017 |
Permanent |
CLAVIJO, LAURA
908 CLARK CIRCLE
FLEMINGTON, NJ 08822
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/28/2017 |
|
CLAYTON, ROBERT (RN)
14 WALNUT DRIVE
BURLINGTON, NJ 08016
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/16/2022 |
|
CLEMENTE, JOHN (MD)
20 PILGRIM WAY
COLTS NECK, NJ 07722
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/29/2015 |
|
CLEMENTE, JOHN (MD)
20 PILGRIM WAY
COLTS NECK, NJ 07722
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/20/2015 |
|
CLEMMENTS, RALPH W. (MD)
7304 CENROSE CIRCLE
WESTWOOD, NJ 07675
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/12/2008 |
|
CLINTON, MICHAELLA a/k/a MICHAELLA JAKA (CHHA)
9 KINGSTON LANE
SOUTH BRUNSWICK, NJ 08852
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/27/2025 |
|
COACHI, DANIEL P. (MD)
209 STENTON AVENUE
BLUE BELL, PA 19422
NPI-1245222991 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/25/2021 |
|
COACHI, DANIEL P. (MD)
581 HAWTHORNE LANE
HARLEYSVILLE, PA 19437
NPI-1245222991 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2024 |
|
COBB, ROY (MD)
504 SUMMIT AVENUE
MAPLEWOOD, NJ 07040
NPI-1548350556 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/5/2017 |
Permanent |
COBB, WILLIAM A. (MD)
2 WEST RIVER STYX ROAD
HOPATCONG, NJ 07843
NPI-1679666903 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/16/2011 |
Permanent |
COCCO, KRISTEN
44 SYRACUSE DRIVE
CHERRY HILL, NJ 08056
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/5/2017 |
|
CODDINGTON, DE'LYNNE (CHHA)
904 MAIN STREET
BRADLEY BEACH, NJ 07720
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/8/2017 |
|
COHEN, BARRY E.
6326 NW 80TH TERRACE
POMPANO BEACH, FL 33067
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/20/2006 |
|
COHEN, DAVID a/k/a LIOR A. ATIYAS SR.
136 LEFFERTS ROAD
WOODMERE, NY 11598
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2024 |
|
COHEN, JUDAH L. (MD)
1000 GALLOPING HILL RD.
UNION, NJ 07083
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/24/1998 |
Permanent |
COHEN, MITCHELL (MD)
144 WHITE CAP LANE
NEWPORT COAST, CA 92657
NPI-1114972874 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2020 |
|
COHEN, ROBERT G. (RN/APN)
51 KRISTEN COURT
MATAWAN, NJ 07747
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/24/2003 |
|
COHEN, WENDY E. (MD)
151 N. DEAN STREET
ENGLEWOOD, NJ 07631
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/10/2012 |
DECEASED |
COLADONATO, JOSEPH P. (MD)
9760 EVERGREEN AVENUE
SEAFORD, DE 19973
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/3/2006 |
|
COLBERT, DONNA (CHHA)
183 ROUTE 35
WALL TOWNSHIP , NJ 07719
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/14/2017 |
Permanent |
COLE, LISA
13764 E. CALEY DRIVE
CENTENNIAL, CO 80111
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/10/2025 |
|
COLE, LISA
13764 E. CALEY DRIVE
CENTENNIAL, CO 80111
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/10/2025 |
|
COLE, LISA
13764 E. CALEY DRIVE
CENTENNIAL, CO 80111
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2025 |
|
COLEMAN, BARBARA (CHHA)
81 LINCOLN PARK, APT. 5B
NEWARK, NJ 07102
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
COLEMAN, BETH (RN)
12 NORTH ELMIRA STREET
ATHENS, PA 18810
NPI-1598919466 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/12/2016 |
|
COLEMAN, WHITNEY (CHHA)
115 LAPIERRE AVENUE
LAWNSIDE, NJ 08045
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/29/2024 |
|
COLETTI, ROGER (MD)
324 CAPTAINS CL
LEWES, DE 19958
NPI-1770508053 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/5/2018 |
Permanent |
COLEY, CHERYL (CHHA)
17 NORTH 3RD STREET
PATERSON, NJ 07522
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/22/2018 |
|
COLLIER, BERT D. (MD)
4933E N. WINDWOOD AVENUE
MILWAUKEE, WI 53217
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/29/2001 |
9/20/2013 |
COLLIER, KENYA (CHHA)
708 THIRD AVENUE, APT. 13-B
ASBURY PARK, NJ 07712
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
3/28/2024 |
COLLIER, KISHA (CHHA)
54 FEDERAL COURT
GALLOWAY, NJ 08205
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2017 |
5/31/2022 |
COLLIER, SARA (MD)
2825 NW 155TH STREET
EDMOND, OK 73013
NPI-1750556924 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/15/2023 |
|
COLLINS, JEAN (RN)
218 COPELAND AVENUE
LYNDHURST, NJ 07071
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/24/2018 |
|
COLON, KAREN L. (LPN)
1020 MCGUIRE DRIVE
TOMS RIVER, NJ 08753
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2005 |
|
COLON-TORRES, FRANCIS M.
437 STUYVESANT AVENUE
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/7/2008 |
|
COMESANAS, MARIO (MD)
COLUMBIA TPK.
FLORHAM PARK, NJ 07932
NPI-1508922659 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/10/2007 |
Permanent |
COMPAS, JEAN CLAUDE (MD)
255 EASTERN PARKWAY
BROOKLYN, NY 11238
NPI-1720178148 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2015 |
|
COMRIE, SHIRLEY M. (CHHA)
7 DUFFELD DRIVE
TRENTON, NJ 08628
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/18/2002 |
|
CONARD, MICHELLE (LPN)
16 ELDRIDGE AVENUE
TRENTON, NJ 08648
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2009 |
|
CONDON, MARJORIE (DO)
327 FRANKLIN AVENUE
RIDGEWOOD, NJ 07450
NPI-1528098068 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/2/2019 |
|
CONNER, BYRON (MD)
15418 CRUISER STREET, UNIT A
CORPUS CHRISTI, TX 78418
NPI-1669412243 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2018 |
|
CONNERS, LAURA (LPN)
11 FENWAY ROAD
HAMILTON, NJ 08620
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/20/2002 |
|
CONOVER, WILLIAM S. (LPN)
225 RUTLAND AVE.
MT. HOLLY, NJ 08060
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2004 |
|
CONTE, SALVATORE (MD)
NEW YORK RRM, PO BOX 329014
BROOKLYN, NY 11232
NPI-1174688493 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/3/2019 |
|
CONTEH, AMARA S. (MD)
3 OLD TAPPAN ROAD
OLD TAPPAN, NJ 07675
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2007 |
|
CONTEH, HAWANATU (CHHA)
531 EMORY AVENUE
TRENTON, NJ 08611
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/4/2025 |
|
CONTI, VINCENT (MFT)
180 PROSPECT AVENUE
MORRIS PLAINS, NJ 07950
NPI-1023189644 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/23/2016 |
|
CONZO, THOMAS
236 FINLAY STREET
STATEN ISLAND, NY 10307
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/5/2025 |
|
COPLIN, BRUCE (MD)
7 HOSPITAL DRIVE
TOMS RIVER, NJ 08755
NPI-1699755868 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/6/2021 |
|
COPLIN, GEORGE J. (MD)
528 EAST JERSEY ST
ELIZABETH, NJ 07206
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
DECEASED |
COPPOLA, KELLY AKA FURLONG, KELLY (PHARM TECH)
52 CORNELL DRIVE
HAZLET, NJ 07730
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/23/2016 |
|
CORNELY, MICHAEL P. (DC)
6650 BROWINING ROAD
MERCHANTVILLE, NJ 08109
NPI-1326199803 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
CORREA-HUNTER, LOUISA (DDS)
372 FOREST AVENUE
PARAMUS, NJ 07652
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/22/2010 |
|
CORSON KENNETH E. (MD)
5 SOUTH MYRTLE ST
VINELAND, NJ 08360
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
DECEASED |
Permanent |
CORTEZ, JESSICA (CHHA)
114 EDWARDS AVENUE
LANDISVILLE, NJ 08326
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/6/2017 |
|
COSENTINO, MARIA P.
140 HARTMANN AVENUE
GARFIELD, NJ 07026
NPI-1215257951 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/31/2024 |
|
COSTA, LAWRENCE J.
441 PENN AVE.
FORKED RIVER, NJ 08731
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
COSTA, RICHARD (DO)
16 BRIDLE COURT
CHERRY HILL, NJ 08003
NPI-1982693511 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2023 |
|
COSTAS, PETER J.
2430 NE 10TH TER
POMPANO BEACH, FL 33064
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/20/2022 |
|
COSTIGAN, KEVIN (LCSW)
132 FRANKLIN AVE, APT. 2
LONG BRANCH, NJ 07740
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/21/2000 |
|
COSTINO JR., JOHN (DO)
404 SURF AVENUE
WILDWOOD, NJ 08260
NPI-1811978414 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/18/2011 |
|
COTTRELL, LISA L. (CHHA)
290 ROUTE 9 NORTH APT C5
WARETOWN, NJ 08758
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/30/2010 |
|
COUCH, SUSAN (CHHA)
10 PLACID LANE
WILLINGBORO, NJ 08046
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
COUGHLIN, CATHERINE K. (RN)
PO BOX 22
LIMESTONE, PA 16234
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/18/2009 |
|
COULTON, DIANE (LPN)
272 BIRCH DRIVE
LEVITTOWN, PA 19054
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/13/2018 |
|
COVERDALE, JULIE ANN (RN)
909 CINNAMINSON AVE.
PALMYRA, NJ 08065
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/20/2003 |
|
COVILLE, FREDERICK A. (MD)
230 N. MAPLE AVENUE
MARLTON, NJ 08050
NPI-1679728307 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/17/1997 |
8/16/2012 |
COVILLE, FREDERICK A. (MD)
51-37 HAVEN AVENUE
OCEAN CITY, NJ 08226
NPI-1679728307 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/26/1998 |
8/16/2012 |
COVONE, DOMINICK (DME OWN)
FORT DIX F.C.I. BOX 38
FORT DIX, NJ 08640
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/18/2001 |
Permanent |
COWAN JR., JAMES (MD)
572 WEST SADDLE RIVER ROAD
RIDGEWOOD, NJ 07450
NPI-1063527026 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2016 |
Permanent |
COWAN JR., JAMES (MD)
28 W. 3RD STREET, APT. 1347
SOUTH ORANGE, NJ 07079
NPI-1063527026 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/6/2017 |
Permanent |
COWAN, MARYANNE (LCSW)
572 WEST SADDLE RIVER ROAD
RIDGEWOOD, NJ 07450
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/21/2016 |
DECEASED |
COWINS, KIMBLIN A. (LPN/CHHA)
75 SHADY LANE
HAMBURG, NJ 07419
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2024 |
|
COWINS, KIMBLINS (CHHA)
75 SHADY LANE
HAMBURG, NJ 07419
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2019 |
Permanent |
COWINS, KIMBLINS (LPN)
75 SHADY LANE
HAMBURG, NJ 07419
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2019 |
|
CRAPANZANO SR., PETER (DDS)
46 VILLAGE COURT
HAZLET, NJ 07730
NPI-1861566960 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/26/2011 |
|
CRAWFORD, KENNETH (CNA)
B-8 ABBINGTON DRIVE
PHILLIPSBURG, NJ 08865
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/6/2006 |
|
CRAWFORD, KENNETH (CNA)
199A FIDDLER ELBOW ROAD
PHILLIPSBURG, NJ 08865
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2006 |
|
CRAWFORD, MODINAT (CHHA)
916 S. 18TH STREET
NEWARK, NJ 07105
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/12/2024 |
|
CRAY, JASON E. (COTT. AID)
WARREN COUNTY JAIL
BELVIDERE, NJ 07823
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/21/2000 |
Permanent |
CRESTA, NICOLE AKA RIVERA, NICOLE (RN)
2009 KICKAPOO TERRACE
VINELAND, NJ 08361
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/28/2017 |
3/24/2026 |
CRISCITO, MARIO (MD)
32 CHELSEA DRIVE
LIVINGSTON, NJ 07039
NPI-1063411957 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/1/2017 |
Permanent |
CRISSIEN, CINDY
78 FORNELIOUS AVENUE
CLIFTON, NJ 07013
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/18/2007 |
|
CRITCHFIELD, CYNTHIA AKA SULLIVAN, CYNTHIA (RPH)
PIN OAK COURT
SHAMONG, NJ 08088
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/20/2008 |
6/15/2017 |
CROCKER JR., KENNETH W.
15 VIOLA AVENUE
LEONARDO, NJ 07737
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
7/17/2009 |
7/17/2014 |
CROMARTIE, CHERISE (CHHA)
25 RONALD ROAD
LAKEWOOD, NJ 08701
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/19/2018 |
|
CRON, EVA (RN)
31 CHERRY STREET
WARWICK, NY 10990
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/27/2007 |
|
CROUSE, FARRELL R. (MD)
101 NORTH MAIN STREET
WOODSTOWN, NJ 08098
NPI-1386795292 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/18/2015 |
|
CROWDER, CLAXTON L. (MD)
115 ASHBY COURT
MOUNT LAUREL, NJ 08054
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/13/2006 |
|
CROWLEY, TERRI (RN)
5 THOREAU ROAD
HAMILTON SQUARE, NJ 08690
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/13/2017 |
|
CRUCIANI, RICARDO (MD)
77 HUDSON STREET, APT. 4401
JERSEY CITY, NJ 07302
NPI-1881615268 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/16/2018 |
Permanent |
CRUZ III, ORLANDO (LPN)
10 ORCHID STREET APT 19
PASSAIC, NJ 07055
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/11/2022 |
1/15/2025 |
CRUZ, ANGELICA (CHHA)
2566 SOUTH 8TH STREET
CAMDEN, NJ 08104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/14/2017 |
|
CRUZ, DELIA (CHHA)
3 RAY PLACE
FAIRFIELD, NJ 07004
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/5/2018 |
|
CRUZ, EDNA (CHHA)
PO BOX 535
VINELAND, NJ 08362
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
CRUZ, JAHAIRA (CHHA)
559 BAILEY STREET
CAMDEN, NJ 08102
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2017 |
|
CRUZ, MARIA C.
128-65 MCCARTHY CIRCLE
PHILADELPHIA, PA 19154
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
12/5/2003 |
|
CRUZ-SLEDGE, ANICIA
13 Tremont Street Apt 2
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/3/2015 |
|
CUETO, PAOLA (CHHA)
619 THIRTY-EIGHTH STREET
UNION CITY, NJ 07087
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/20/2017 |
|
CUFFARI, CHRISTOPHER
FCI LEWISBURG, P.O. BOX 1000
LEWISBURG, PA 17837
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2024 |
|
CUFFARI, JOHN
FCI OTISVILLE, PO BOX 1000
OTISVILLE, NY 10963
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2024 |
|
CUFFE, MAXINE (RN)
33 GREENBROOK DRIVE
BLOOMFIELD, NJ 07003
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/3/2017 |
8/22/2019 |
CUI, XIN (CHHA)
119 S. ADELAIDE LANE
HIGHLAND PARK, NJ 08904
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/24/2008 |
|
CULLEN, CHARLES (RN)
PO BOX 861
TRENTON, NJ 08625
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/18/2007 |
|
CULLEN, KENNETH
100 MARSHALL AVENUE
TUCKERTON, NJ 08087
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
1/19/2010 |
|
CUNNINGHAM, BRUCE D. (DO)
213 WAYNE DRIVE
CINNAMINSON, NJ 08077
NPI-1912031907 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/27/2025 |
|
CUNNINGHAM, MICHAEL D. (MD)
PO BOX 505
GLEN SPEY, NY 12737
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2002 |
|
CUPO, DAWN (LPN)
129 ADELPHIA ROAD
FARMINGDALE, NJ 07727
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2001 |
|
CUPOLO, STACY J. (DENTAL HYGIENTIST)
897 INVERNESS CT. APT. A
LAKEWOOD, NJ 08701
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2005 |
|
CURETON, WILLIE T.
61 CHELSEA AVENUE
NEWARK, NJ 07106
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/27/2011 |
|
CURETON, WILLIE T.
5 UNAMI LANE
SCOTCH PLAINS, NJ 07076
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/23/2009 |
Permanent |
CURRY, CHARLES M. (MD)
816 BURNT MILLS ROAD
OLDWICK, NJ 08858
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
CURTY, LISA
193 PLEASANT PLAINS AVENUE
STATEN ISLAND, NY 10309
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
6/14/2024 |
|
CURTY, LISA
193 PLEASANT PLAINS AVENUE
STATEN ISLAND, NY 10309
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/20/2024 |
|
CUSTIS, KEVIN (MD)
908 MAIN STREET
ASBURY PARK, NJ 07712
NPI-1811976970 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/22/2017 |
Permanent |
CUTLER, JAZMERE (LPN)
131 HUNTLEY AVENUE
BAYVILLE, NJ 08721
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/17/2019 |
|
CUVIELLO, CHRISTINA (LPN)
1647 WHITTIER AVENUE
TOMS RIVER, NJ 08753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/24/2018 |
|
CZYZYK, LISA M. (RN)
12 VILLAGE COURT APT A
TRENTON, NJ 08690
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/13/2013 |
|
DACONTI, JOHN (DO)
13 MEDFORD ROAD
MORRIS PLAINS, NJ 07950
NPI-1063460939 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/13/2016 |
|
DADAIAN, JON PAUL (MD)
77 W 24TH STREET, APT 21H
NEW YORK, NY 10010
NPI-1629081013 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/21/2023 |
|
DAFTARY, REKHA B. (MD)
81 B EAST MAIN STREET
MENDHAM, NJ 07943
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/29/2008 |
|
DAHAB, YASIR
5 PARK STREET
ROSELAND, NJ 07068
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/12/2001 |
Permanent |
DAHHAN, MOHAMED Z. (MD)
WINDING WAY
WEST PATERSON, NJ 07424
NPI-1417279779 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/20/2008 |
4/3/2014 |
DAILY, GALE (CHHA)
14 SUDBERRY LANE
WILLINGBORO, NJ 08046
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/19/2001 |
|
DALDUDADO, ERROL D. (RN)
81 KNICKERBOCKER ROAD
DEMAREST, NJ 07627
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/30/2025 |
|
DALEY, ROBERTA (LPN)
36 HOLLY DRIVE
PARLIN, NJ 08859
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2001 |
|
D'ALLEGRO, FRANK (RPH)
32 SUMMIT AVENIE
CEDAR GROVE, NJ 07009
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/5/1990 |
Permanent |
DALMACY, KESLER
3427 COLONY DRIVE
BALDWIN, NY 11510
NPI-1306037940 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/15/2022 |
|
DALTON, ERIN (RN)
14 VICTORIAN WAY
WEST DEPTFORD, NJ 08090
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
2/20/2013 |
10/27/2020 |
DALY, JAMES J. (EMT)
504 EAST FRANKLIN AVENUE
EDGEWATER PARK, NJ 08010
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/7/2013 |
|
DALY, LAUREN (MD)
SCI CAMBRIDGE SPRINGS, 451 FULLERTON AVENUE
CAMBRIDGE SPRINGS, PA 16403
NPI-1952492233 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/5/1990 |
|
DALY, LAUREN (MD)
SCI CAMBRIDGE SPRINGS, 451 FULLERTON AVENUE
CAMBRIDGE SPRINGS, PA 16403
NPI-1952492233 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
D'AMICO, DENNIS (RPH)
91 OTTOWA RD SOUTH
MARLBORO, NJ 08817
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/11/1985 |
Permanent |
DAMMERS, SEAN
255 SANTIAGO AVE
RUTHERFORD, NJ 07070
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
9/2/2012 |
|
DANESHVAR, GERALD (MD)
3425 LONE PINE ROAD
WEST BLOOMFIELD, MI 48323
NPI-1548427164 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2018 |
|
DANIEL, ALAN (LCSW)
3 HARRISON PARK LANE
BURLINGTON, NJ 08016
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
3/17/2000 |
|
DANIEL, ALAN L. (LCSW)
415 KEIM BOULEVARD
BURLINGTON, NJ 08016
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/1999 |
|
DANIEL, ALAN L. (LCSW)
202 SPRING GARDEN RD
ANCORA, NJ 08037
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/20/2002 |
|
DANIEL, THERESA D.
3 HARRISON PARK LANE
BURLINGTON, NJ 08016
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
3/17/2000 |
|
DANIEL-CONOVER, NAHLA (CHHA)
191 RUTLEDGE AVENUE
EAST ORANGE, NJ 07017
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/1/2017 |
|
DANIELS, BERLYN E. (CHHA)
WHITE HORSE AVENUE
TRENTON, NJ 08610
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/13/2008 |
|
DANIELS, CLIFTON
37 HUGHES STREET
MAPLEWOOD, NJ 07040
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
7/17/2009 |
7/17/2014 |
D'ANJOU, TANYA LAUR aka BLAIR, TONYA LAUR
624 FIG STREET
SCRANTON, PA 18505
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/2024 |
|
D'ANTIGNAC, CHARLOTTE
3 CHURCHILL DOWNS
W. LONG BRANCH, NJ 07764
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/10/2000 |
|
DARA, PARVEZ (MD)
214 COMMONS WAY, BLDNG B
TOMS RIVER, NJ 08755
NPI-1215952775 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/12/2011 |
|
DARBY, MARK
1245 ADEE AVENUE, APT 4C
BRONX, NY 10469
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
11/18/2010 |
|
DARBY, MARK
SBI305830E, EJSP
RAHWAY, NJ 07065
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
1/1/2010 |
|
DARQUAH, JOSEPHINE (RN/LPN/CHHA)
500 ADAMS LANE, APT 10J
NORTH BRUNSWICK, NJ 08902
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2024 |
|
D'ASCOLI, BARTHOLOMEW (MD)
PO BOX 1869
MONTAGUE, NJ 07827
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/18/2000 |
Permanent |
DASS, SUMAN K. (MD)
4 BALDWIN AVENUE
JERSEY CITY, NJ 07304
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/4/2000 |
Permanent |
DATCHER, ANTHONY
SCI DALLAS, FOLLIES RD., DRAWER K
DALLAS, PA 18612
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
DATESHIDZE, JANE (RPH)
617 STOKES ROAD, SUITE 4
MEDFORD, NJ 08055
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
6/28/2017 |
|
DATILUS, SHELSIE (CHHA)
533 NORWOOD STREET, FL. 1
EAST ORANGE, NJ 07018
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/22/2017 |
Permanent |
DAVID, GABRIELLA (CHHA)
130 W 49th STREET
BAYONNE, NJ 07002
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/31/2023 |
8/16/2023 |
DAVID, RICHARD
819 EDGEWOOD AVENUE
TRENTON, NJ 08618
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
9/17/2009 |
2/17/2016 |
DAVID, VANESSA (LPN)
204 N. 17TH STREET
BLOOMFIELD, NJ 07003
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/17/2018 |
|
DAVIS, ANTOINETTE
43 VERNON COURT
SICKLERVILLE, NJ 08081
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/23/2007 |
|
DAVIS, CHARLES M. (COUNSELOR)
381 BALA AVENUE
BALA CYNWYD, PA 19004
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/31/2008 |
|
DAVIS, CONITA (CHHA)
2 SUTTON DRIVE, APT. O-1
MATAWAN, NJ 07747
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/7/2017 |
|
DAVIS, COREY
25 JAMES STREET
LAKEWOOD, NJ 08701
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/12/2006 |
|
DAVIS, DEYSHA
12250 ATLANTIC BOULEVARD
JACKSONVILLE, FL 32225
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
DAVIS, ESTELLE (CHHA)
71 HAMILTON STREET
EAST ORANGE, NJ 07017
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/31/2018 |
|
DAVIS, JAMES DANIEL
145 JUNIPER ST
BROWNS MILLS, NJ 08015
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/4/1988 |
Permanent |
DAVIS, JAMES S.
41 B TROY DRIVE
SPRINGFIELD, NJ 07081
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/4/1986 |
9/4/1994 |
DAVIS, JEFFREY (MD)
5 EAST 63RD STREET
NEW YORK, NY 10065
NPI-1548258189 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/22/2016 |
|
DAVIS, KARIN B. (RN)
141 EAST BENNETT AVE.
WILDWOOD, NJ 08260
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2002 |
4/14/2014 |
DAVIS, LORETTA (CHHA)
120 CENTRAL PLACE, 202-B
ORANGE, NJ 07050
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/19/2018 |
|
DAVIS, MARK S. (DPM)
5 MONTANA DRIVE
COLTS NECK, NJ 07722
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
4/9/2004 |
|
DAVIS, MATHILDA (MD)
230 W JERSEY ST
ELIZABETH, NJ 07202
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/13/1985 |
Permanent |
DAVIS, NICOLE (RN)
544 ACKLEY ROAD
NEWPORT, NJ 08345
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/4/2018 |
12/20/2023 |
DAVIS, SHANTA (LPN)
114 PLUMTREE LANE
WILLINGBORO, NJ 08046
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/11/2019 |
|
DAVIS, SHARAE (CHHA)
116 LANFORD STREET
ASBURY PARK, NJ 07712
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
DAVIS-HARVEY, DIANA (RN)
10 CAMINO COURT
SICKLERVILLE, NJ 08081
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/15/2017 |
8/6/2021 |
DAVIT, SAMUEL (MD)
100 WINSTON DRIVE #B
CLIFSIDE PARK, NJ 07010
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/20/2003 |
|
DAVYDOV, ALBERT
6536 WETHEROLE STREET, APT 411
REGO PARK, NY 11374
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/8/2024 |
|
DAWLEY, ASHALEY (CHHA)
247 MORSE STREET
CAMDEN, NJ 08105
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/19/2018 |
|
DAWOUD, MONIR A. (MD)
7 COLTSFOOT GLEN
SADDLE RIVER, NJ 07458
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/13/2008 |
|
DAWOUD, MONIR A. (MD)
7 COLTSFOOT GLEN
SADDLE RIVER, NJ 07458
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/4/2007 |
|
DAWSON, LATIA (CHHA)
838 4TH AVENUE
NEPTUNE, NJ 07753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/14/2017 |
11/9/2020 |
DE LA ROSA ACOSTA, BIENVENIDA (CHHA)
355 OAK STREET, APT. 8
PASSAIC, NJ 07055
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
DEAN, ARLENE (CHHA)
34 WEST UNION STREET, APT. A
BURLINGTON, NJ 08016
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/3/2019 |
|
DEAN, RANDY (MD)
3391 NORTH WEST 99TH AVENUE
CORAL SPRINGS, FL 33065
NPI-1083924807 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
DEANGELO, KRYSTAL (RN)
1314 HANCOCK AVENUE
VANDERGRIFT, PA 15690
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
DEAQUINO, ANTHONY
11 STONE RIDGE LANE
HO-HO-KUS, NJ 07423
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/19/2002 |
|
DEBARO, GERRI (RN)
3715 ROYCE COURT
HILLSBOROUGH, NJ 08844
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/12/2019 |
|
DEBIASI, RICK (DC)
1 ASHLEY PLACE
TOWACO, NJ 07082
NPI-1861415655 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/30/2016 |
|
DECASTRO, ANGELA (LPN)
894 GOSHEN ROAD
CAPE MAY CRT HSE, NJ 08210
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/29/2016 |
|
DEEMI, SAMUEL
665 MARTIN LUTHER KING BL
NEWARK, NJ 07102
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/27/2010 |
|
DEFEO, DELORES A. (CNA)
RR #6 BOX 280-D
PLEASANTVILLE, NJ 08232
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/26/1996 |
Permanent |
DEGILIO, MICHAEL (PSYD)
144 DOGWOOD DRIVE
JIM THORPE, PA 18229
NPI-1356329528 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
DEGIROLAMO, MATTHEW
224 PARK RIDGE DRIVE
EASTON, PA 18040
NPI-1730102450 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2024 |
|
DEGUZMAN, DAISY (MD)
111 MULBERRY STREET
NEWARK, NJ 07102
NPI-1699865097 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2014 |
9/22/2020 |
DEIXLER, GLENN (CHHA)
262 PRIVATEER ROAD
MANAHAWKIN, NJ 08050
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/19/2018 |
|
DEJESUS, YAZMIN (CHHA)
654 OHIO AVENUE
EWING, NJ 08638
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2019 |
|
DEKU, FAUSTINA (CHHA)
10 MARSHALL STREET
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
DEL PIANO, ANTHONY (MD)
24 DRINKING BROOK ROAD
MONMOUTH JUNCTION, NJ 08052
NPI-1922032770 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/15/2015 |
4/1/2022 |
DELA GENTE, ROBERT AKA DELAGENTE, ROBERT (MD)
12 HUNTERS RUN
OAKLAND, NJ 07436
NPI-1891886230 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/12/2019 |
|
DELA GENTE, ROBERT S. aka ROBERT DELAGENTE (DO)
P.O. BOX 2000
JOINT BASE MDL, NJ 08640
NPI-1891886230 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/20/2023 |
|
DELACRUZ, AMELITA (CHHA)
62 LEXINGTON AVENUE
JERSEY CITY, NJ 07306
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/28/2018 |
|
DELAGENTE, ROBERT AKA DELA GENTE, ROBERT (MD)
12 HUNTERS RUN
OAKLAND, NJ 07436
NPI-1891886230 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/12/2019 |
|
DELANCEY, WAYNE K. (PHARM TECH)
1020 HIDEAWAY COURT
VINELAND, NJ 08361
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/16/2011 |
|
DELAURENTIS, REGINA P (LPN)
102 TENNYSON DRIVE
PLAINSBORO, NJ 08536
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/20/2023 |
|
DeLEON, NOEL
110 MORGAN PLACE
NORTH ARLINGTON, NJ 07031
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/13/2023 |
|
DELEON, NOEL
110 MORGAN PLACE
NORTH ARLINGTON, NJ 07031
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/18/2024 |
|
DELGADO, NICOLE (RN)
81 WALNUT STREET
OAKLAND, NJ 07436
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/29/2018 |
1/26/2024 |
DELGADO, YOKATI (CHHA)
175 BRIGHTON AVENUE
PERTH AMBOY, NJ 08861
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
DELIA, MICHELLE
545 W. HILL ROAD
GLEN GARDNER, NJ 08826
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/7/2010 |
|
DELLAPENNA, LINDA (CNA)
52 VAN NESS DRIVE
BRICK, NJ 08723
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/13/2003 |
|
DELLBENI, FRANK (LPN)
P.O. BOX 89
MARTINS CREEK, PA 18063
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/4/2021 |
Permanent |
DELOACH, LORRAINE (CHHA)
9 DAVID STREET, APT. 3
SOUTH RIVER, NJ 08882
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
DELUANTO, LILIANA (CHHA)
1160 SUMMIT LANE
MOUNTAINSIDE, NJ 07092
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/2/2018 |
|
DELUCA, ANTHONY (MD)
630 PRINCETON AVEMUE
BRICK, NJ 08724
NPI-1043257744 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/16/2015 |
|
DELUCA, ANTHONY (MD)
FCI-FORT DIX, PO BOX 2000
JOINT BASE MDL, NJ 08640
NPI-1043257744 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/11/2016 |
|
DELUCA, WENDY (LPN)
108 GRANDVIEW ROAD
HIGHLAND LAKES, NJ 07422
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/15/2018 |
|
DEMARCO, CHARLENE C. (DO)
P O BOX 898801
OKLAHOMA CITY, OK 73189
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/20/2008 |
|
DEMARIA JR., WILLIAM R. ( AGENT)
104 WINDSOR COURT
PALM BEACH, FL 33480
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
1/5/2001 |
|
DEMASSI, MICHAEL A. (LCSW)
1917 WATERS EDGE DRIVE
TOMS RIVER, NJ 08753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/20/2013 |
|
DEMBOSKE, RICHARD MICHAEL (RN)
557 WILLOW AVENUE
SADDLE BROOK, NJ 07663
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/22/2022 |
|
DEMEO, ROBERT (MD)
522 TYSENS LANE, 2ND FL.
STATEN ISLAND, NY 10306
NPI-1043220262 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/23/2015 |
|
DEMOSS, KATHLEEN M. (DC)
14 N. MAIN STREET
FLEMINGTON, NJ 08822
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/19/2001 |
|
DENNIS, MOSES (LPN)
625 GREENWAY AVENUE
DARBY, PA 19023
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/18/2018 |
Permanent |
DENT, VALERIE (RN)
325 ROLLING KNOLLS ROAD
SCOTCH PLAINS, NJ 07076
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/7/2022 |
|
DENUCCI, NICHOLAS
51 BARN OWL
HACKETTSTOWN, NJ 07840
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/24/2002 |
|
DEORIO, ANA G. (RN)
COLUMBIA AVENUE
NORTH BERGEN, NJ 07047
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/18/2007 |
|
DEPHILLIPS, DONNA (MD)
7 WESTMINSTER PLACE
OLD TAPPAN, NJ 07675
NPI-1386657971 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/15/2023 |
|
DEROSIER-BEAUBRUN, SABRINA (CHHA)
754 SOUTH BROAD STREET
TRENTON, NJ 08611
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/28/2018 |
|
DERRICK, NAOMI AKA BASCUS, NAOMI (RN)
6 ENGLISH IVY DRIVE
SICKLERVILLE, NJ 08081
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/9/2020 |
|
DERRICK, NAOMI AKA BASCUS, NAOMI (RN)
6 ENGLISH IVY DRIVE
SICKLERVILLE, NJ 08081
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/26/2016 |
|
DESAI, BAKUL (MD)
15 MOUNTAIN RIDGE DRIVE
LIVINGSTON, NJ 07039
NPI-1376654624 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
3/8/2010 |
9/10/2019 |
DESAI, BAKUL (MD)
15 MOUNTAIN RIDGE DRIVE
LIVINGSTON, NJ 07039
NPI-1376654624 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2012 |
9/10/2019 |
DESAI, NEMISH (DDS)
248 BOONTON TURNPIKE
LINCOLN PARK, NJ 07035
NPI-1598908295 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/18/2019 |
3/5/2024 |
DESAI, USHA (DDS)
23 REYNOLDS AVENUE
PARSIPPANY, NJ 07054
NPI-1407988173 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
5/2/2023 |
10/5/2023 |
DESAI, USHA (DDS)
23 REYNOLDS AVENUE
PARSIPPANY, NJ 07054
NPI-1407988173 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/5/2023 |
|
DESANTIS, ANTHONY (RPH)
105 FRANKLIN STREET
BELLEVILLE, NJ 07109
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/24/2003 |
|
DESIMONE, EUGENE (MD)
FCI FORT DIX, PO BOX 38
JOINT BASE MDL, NJ 08640
NPI-1427098268 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/28/2015 |
|
DESIR, MELISSA (CHHA)
20 WILLOW DRIVE, APT. 8
OCEAN, NJ 07712
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/18/2017 |
10/21/2025 |
DESTASIO, VINCENT (MD)
1851 HOOPER AVENUE
TOMS RIVER, NJ 08753
NPI-1043215650 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/13/2016 |
|
DESTASIO, VINCENT (MD)
1851 HOOPER AVENUE
TOMS RIVER, NJ 08753
NPI-1043215650 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/12/2016 |
5/13/2016 |
DETROLIO, DANIEL (RN)
23 FOXWOOD DRIVE, APT. D
MORRIS PLAINS, NJ 07950
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/27/2018 |
|
DEVARIS, HELENA D. (DMD)
35-08 MORLOT AVENUE 1X
FAIR LAWN, NJ 07410
NPI-1679723589 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/21/2013 |
|
DEVARSO, ANGELA (RN)
FCI DANBURY, RTE 37
DANBURY, CT 06811
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
5/20/2012 |
12/18/2023 |
DEVERA, MONICA T.
118 BEACON STREET
DUMONT, NJ 07628
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2002 |
|
DEVLIN, JACK a/k/a JOHN CALLANAN DEVLIN
9621 OAK SUMMIT AVENUE
PARKVILLE, MD 21234
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2024 |
|
DEVLIN, JOHN CALLANAN a/k/a JACK DEVLIN
9621 OAK SUMMIT AVENUE
PARKVILLE, MD 21234
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2024 |
|
DEVLIN, MARYELLEN (RN)
809 DEVON ROAD
RIVERSIDE, NJ 08075
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/4/2018 |
Permanent |
DEZENHALL, MERVIN (RPH)
SUNSET RD AT SUMMIT TURN
WILLINGBORO, NJ 08046
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
DI SPALTRO, FRANKLIN L. (MD)
MELROSE LANE
GREEN VILLAGE, NJ 07935
NPI-1740627082 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/18/2007 |
|
DIAZ, CHRISTINA (CHHA)
40 MORRIS STRET, APT. 402
PASSAIC, NJ 07055
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/22/2019 |
12/16/2025 |
DIAZ, JENNIFER MARTE (CHHA)
534 SUMMER STREET, FL 1
PATERSON, NJ 07501
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/11/2025 |
|
DIAZ, PEDRO P.
80 SKYTOP ROAD
NEWTON, NJ 07860
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2011 |
|
DIAZ-PELLOT, NORMA
500 BERKELY DRIVE
BROWNS MILLS, NJ 08015
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/24/2000 |
Permanent |
DIAZ-PELLOT, NORMA
258 UNIVERSITY AVE
PEMBERTON, NJ 08068
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2001 |
Permanent |
DICARLO, ANTHONY G.
35 GALT OCEAN DR
FT LAUDERDALE, FL 33308
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
DICICCO, RICHARD (DC)
1 MYERS AVENUE
BERLIN, NJ 08009
NPI-1073668265 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/5/2017 |
|
DICK, SHONDELL (CHHA)
196 22ND STREET
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/29/2018 |
Permanent |
DICKERSON, DENISE M. (RN)
126 HILLCREST AVE, 2A
BLACKWOOD, NJ 08012
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/22/2010 |
|
DICKSON, DESHAY
203 GLEN PARK
BRIDGETON, NJ 08302
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/25/2025 |
|
DICOVSKIY, CLAUDIO (MD)
1308 ABBOTT BOULEVARD
FORT LEE, NJ 07024
NPI-1932282845 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/7/2017 |
11/13/2023 |
DICOVSKIY, CLAUDIO (MD)
1308 ABBOTT BOULEVARD
FORT LEE, NJ 07024
NPI-1932282845 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/23/2015 |
11/13/2023 |
DICUBELLIS, MICHELE R. (LCSW)
4030 ANDERSON AVE, SE
ALBURQUERQUE, NM 87108
NPI- |
Medical
Antitrust/Anti-Kickback Acts |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/23/2011 |
10/22/2014 |
DIEM, MICHELLE C. (CHHA)
821 NEVILLE STREET
TOMS RIVER, NJ 08753
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
9/23/2014 |
|
DIETERLE, KAREN M. (RN)
51 STURBRIDGE DRIVE
SICKLERVILLE, NJ 08081
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/19/2004 |
|
DIETRICH, LISA B.
DOGWOOD TRAIL
RANDOLPH, NJ 07869
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/20/2008 |
|
DIETZ, MICHAEL (CHHA)
1602 AQUEDUCT COURT
TOMS RIVER, NJ 08755
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
DIGIORGIO, DAWN K.
13 EAST PINE ST. 13D
WESTVIEW, NJ 08093
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/19/2004 |
|
DIKENGIL, MEHMET #79773-054 (DDS)
FCI FORT DIX, PO BOX 2000
JOINT BASE MDL, NJ 08640
NPI-1255608279 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/10/2019 |
|
DILER, NISHA a.k.a. NISHA RANA (RPH)
6 BOULDER LANE
HICKSVILLE, NY 11801
NPI-1265831242 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/2022 |
|
DILLARD, LATICIA
4208 NORTH DRIVE
ATLANTIC CITY, NJ 08401
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
8/24/2013 |
|
DILLIGARD, LATASHA (CHHA)
320 W. BRANCH AVENUE, APT. 47C
CAMDEN, NJ 08021
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
DILORENZO, PAUL (MD)
22 NORTHWOODS ROAD
OCEAN, NJ 07712
NPI-1699841056 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/17/2017 |
|
DILUIGI, KENNETH (RN)
RAVENSWOOD WAY
SEWELL, NJ 08080
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
12/17/2008 |
|
DIMEO, ALEXANDER
19355 LASERENA DRIVE
FORT MEYERS, FL 33967
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/3/2017 |
|
DIN, TARIQ
22 CAMERON ROAD
SADDLE RIVER, NJ 07458
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
5/2/2023 |
|
DINKEL, ARTHUR R. (LCSW)
2 FREEMAN LANE
DENVILLE, NJ 07834
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/19/2001 |
Permanent |
DINKEL, ARTHUR R. (LCSW)
2 FREEMAN LANE
DENVILLE, NJ 07834
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/29/2000 |
Permanent |
DIPAOLO, EDMONDO (LPN)
136 DANIELS AVENUE
BROWNS MILLS, NJ 08015
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/9/2020 |
|
DIRENZO, ALFRED M. (DO)
167 GROVE STREET
LODI, NJ 07644
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/21/1995 |
Permanent |
DISCENZA, RONALD (MD)
2578 WOLF HOLLOW ROAD
ANDES, NY 13731
NPI-1528137882 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/17/2017 |
|
DISKINT, JAMES
1616 SOUTH SHERBOURNE DRIVE
LOS ANGELES , CA 90035
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2025 |
|
DISKINT, JULIE a/k/a JULIE CAMELOTTO (PT)
44 MILLER ROAD
MORRISTOWN, NJ 07960
NPI-1093294555 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2025 |
|
DISKINT, NATHANIEL
44 MILLER ROAD
MORRISTOWN, NJ 07960
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2025 |
|
DITURO, JOSEPH (MD)
376 WOOD RIDGE ROAD
WOODRIDGE, NJ 07075
NPI-1194871459 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/15/2016 |
|
DIXIT, DIVY R. (RPH)
3022 EDWARD STEC BLVD
EDISON, NJ 08837
NPI-1619125135 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/30/2015 |
|
DIXON, SHANNON
501 IRVING STREET
CLEMNTON, NJ 08021
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/18/2010 |
3/18/2013 |
DIZON, ZENAIDA K. (RN)
23 WALNUT STREET
JERSEY CITY, NJ 07305
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/12/2025 |
|
DJAMBA, MONDJA (CHHA)
17 PHEASANT ROAD
CLEMENTON, NJ 08021
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/6/2017 |
Permanent |
DJAVID, ISMAIL F.
160 EAST 89TH STREE
NEW YORK CITY, NY 10028
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
DLUZNIEWSKI, MICHELE (RN)
137 STEPHAN ROAD
BRICK, NJ 08724
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/7/2019 |
5/31/2023 |
DOBROWOLSKI, DONALD A. (DMD)
45 BRICK BLVD. S-108
BRICK, NJ 08723
NPI-1184764664 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/1995 |
Permanent |
DOLINER, PAUL (MD)
401 US HIGHWAY 22
N PLAINFIELD, NJ 07060
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/15/1980 |
Permanent |
DOMINIC JR., ANTHONY J. (MD)
216 2ND AVENUE
UPPER MANASQUAN, NJ 08736
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/20/2002 |
|
DONALDSON, DENISE
2650 SPRUCE DRIVE
LAKEHURST, NJ 08733
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/1995 |
DECEASED |
DONALDSON, DENISE
33 3RD AVENUE
TOMS RIVER, NJ 08757
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/9/2003 |
DECEASED |
DONOFRIO, CHRISTINE (RN)
207 TULIP LANE
FREEHOLD, NJ 07728
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/3/2017 |
|
DONOFRIO, DOUG
1 SPRING LAKE DRIVE
FAR HILLS, NJ 07931
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/4/2012 |
|
DONSKY, DMITRY (MD)
126 SHINNECOCK DRIVE
MANALAPAN, NJ 07726
NPI-1407807803 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/15/2022 |
|
DOOLEY, CHRISTOPHER J. (PHD)
10 DEER RUN
FREEHOLD, NJ 07728
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/9/2009 |
|
DORBOR, BONGO (CHHA)
2341 LIBERTY STREET
HAMILTON, NJ 08629
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
DORIA, LAWRENCE (RPH)
6 BROOK PLAZA
JACKSON, NJ 08527
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/7/1984 |
Permanent |
DORSEY, KIONA (CHHA)
670 W. GROVELAND AVENUE
SOMERS POINT, NJ 08244
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/22/2019 |
|
DORVIL, FAUBERT (RN)
651 S. PALM STREET, #201
LITTLE ROCK, AR 72205
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/4/2014 |
|
DOS SANTOS, ISABELLE (LMBT)
464 NORTH AVENUE
ELIZABETH, NJ 07208
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/21/2023 |
|
DOSHI, PRIYAKANT S. (MD)
11 WARFIELD STREET
MONTCLAIR, NJ 08625
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/2/1997 |
DECEASED |
DOSSEN, SEBRENA (CHHA)
24 PHILIP E. FRANK WAY
CLIFFWOOD, NJ 07721
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/29/2018 |
|
DOSSOUS, JONAS (CHHA)
1927 BANGS AVENUE
NEPTUNE, NJ 07753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/17/2017 |
|
DOTOLI, FRANKLIN (MD)
460 FRANKLIN AVE
NUTLEY, NJ 07110
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
DECEASED |
DOTRO, ALYCIA AKA ALEXANDRA, ALYCIA (RN)
6 LOWELL ROAD
MANALAPAN, NJ 07726
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/23/2019 |
|
D'OTTAVIO, PAOLA (RPH)
WILLOW OAKS DR.
MAYS LANDING, NJ 08330
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/4/2007 |
Permanent |
D'OTTAVIO, PAOLA (RPH)
504 WILLOW OAK DRIVE
MAYS LANDING, NJ 08330
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2011 |
|
DOUGHERTY-PRICE, ANITA JO (CHHA)
212 WESTMONT AVENUE
WESTMONT, NJ 08108
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/22/2017 |
|
DOYLE, JUDITH M. (RN)
71 WILDFLOWER LANE
MORRISTOWN, NJ 07960
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/20/2004 |
|
DRAGERT, ROBERT (MD)
12 E. SEUDDER COURT
PENNINGTON, NJ 08534
NPI-1558522821 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/26/2018 |
7/21/2020 |
DRISCOLL, PETER V. (MD)
525 HOPKINS LANE
HADDONFIELD, NJ 08033
NPI-1215276787 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2023 |
|
DRIVAS, GUSTAVE (MD)
FCI LORETTO, PO BOX 1000
LORETTO, PA 15940
NPI-1003867730 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/11/2014 |
|
DRIZAN, LOULEA (CHHA)
43B MANLAY MANOR
ELIZABETH, NJ 07202
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/6/2018 |
|
DROBISH, MICHAEL
147 LITTLE FALLS ROAD
CEDAR GROVE, NJ 07009
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
6/14/2024 |
|
DROBISH, MICHAEL R.
FCI OTISVILLE, PO BOX 1000
OTISVILLE, NY 10963
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/18/2024 |
|
DUAH, GLORIA (CHHA)
68 MYRTLE AVENUE
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
DUARTE, LEONARD (DC)
10 INDEPENDENCE COURT
JACKSON, NJ 08527
NPI-1568681542 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/30/2019 |
|
DUBLIN, DEBORAH a.k.a. BASKERVILLE, DEBORAH (LPN)
130 GIULIA LANE
GALLOWAY, NJ 08205
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/19/2024 |
|
DUBNOFF, MICHELLE (DC)
333 PROVINCIAL DRIVE
MORGANVILLE, NJ 07751
NPI-1225066210 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/20/2018 |
|
DUBOVY, CARL (MD)
11 PIPPINS WAY
MORRISTOWN, NJ 07960
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
DUCHEINE, YVAN (MD)
310 CENTRAL AVENUE
EAST ORANGE, NJ 07018
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/1/2017 |
4/5/2018 |
DUFF, RICHARD W. (RN)
1260 SUMMERLEA AVENUE
WASHINGTON, PA 15301
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2015 |
|
DUFFIELD, CAMI R. (RN)
119 GRAF AVENUE
LAWRENCEVILLE, NJ 08648
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/20/2000 |
|
DUFFY, BARBARA AKA GONZOPH, BARBARA (LPN)
208 WAYNE TERRACE
COLLINGSWOOD, NJ 08108
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/19/2004 |
|
DULL, JOHN W. (DDS)
399 HOOVER AVENUE
BLOOMFIELD, NJ 07003
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
DECEASED |
DUMITRU, DAN (MD)
1657 JFK BOULEVARD FL 1
JERSEY CITY, NJ 07305
NPI-1073639530 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/11/2016 |
|
DUNCAN, ANTHONY (RPH)
566 N UNION AVENUE FL 1
HILLSIDE, NJ 07205
NPI-1245996453 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
6/28/2022 |
|
DUNHAM, GERALD (MD)
60 W. MAIN STREET
CLINTON, NJ 08809
NPI-1528173788 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/27/2025 |
|
DUQUE, IRMA (CHHA)
314 BROADWAY
ELIZABETH, NJ 07206
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/14/2007 |
|
DURFEE, JANET (RN)
103 WOODLAKE DRIVE
MARLTON, NJ 08053
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/20/2004 |
|
DURIVAGE, SHARON (RN/APN)
1655 HUNTERS COURT
YARDLEY, PA 19067
NPI-1407033442 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/4/2018 |
|
DURNIEN, EDWARD (CHHA)
215 CREEK ROAD
KEANSBURG, NJ 07734
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/6/2006 |
|
DURST, LAWRENCE (RPH)
FCI FORT DIX, PO BOX 38
FORT DIX, NJ 08640
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/19/2001 |
|
DWAMENA, ELIZABETH (CHHA)
42 LINDEN AVENUE, APT. 2
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/28/2023 |
|
DWAMENA, ELIZABETH (CHHA)
42 LINDEN AVENUE
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/4/2023 |
|
DYEVICH, KEVIN
193 LIVINGSTON AVENUE
NEW BRUNSWICK, NJ 08901
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/21/1996 |
Permanent |
DYOUS, KEISHA (LPN)
2 BONNIE COURT
LAWRENCEVILLE, NJ 08648
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/24/2018 |
8/22/2019 |
DZIENISIEWSKI, DONNA J. (RN)
9 IVY LANE
MIDDLETOWN, NJ 07748
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/3/2016 |
|
DZUIK, CAROL (CHHA)
416 CABLE AVENUE
BEACHWOOD, NJ 08722
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
EASTBURN, NORMAN W. (DC)
424 MATTHEWS LANE
JACKSON, NJ 08527
NPI-1013056670 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/14/2014 |
3/2/2026 |
EATOUGH, PHILIP (DO)
5 SYCAMORE LANE
RUMSON, NJ 07748
NPI-1972681674 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/26/2010 |
|
EDANIEWSKI, EDWARD R.
113 FRONT STREET
SECAUCUS, NJ 07094
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
EDDIB, LATIFA (CHHA)
8700 LAZY HOLLOW DRIVE, APT. 142
HOUSTON, TX
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2023 |
|
EDMILAO, CANUNITA
645 NEWARK AVE.
JERSEY CITY, NJ 07305
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
4/9/2004 |
|
EDMONDS, KIANNAH (CHHA)
916 4TH AVENUE
WALL TOWNSHIP, NJ 07719
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/6/2017 |
|
EDOUARD, SONORE a/k/a EDOUARD SONORE
4 WINTERBERRY COURT
MILLER PLACE, NY 11764
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/19/2024 |
6/3/2025 |
EGANEY, BETH (LPN)
46 REA AVENUE
MIDLAND PARK, NJ 07432
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/28/2019 |
|
EGBERT, JENNIFER (CHHA)
PO BOX 1129
FORKED RIVER, NJ 08731
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/26/2018 |
1/19/2022 |
EGENBERG, IRIS
153 AVENUE B
BAYONNE, NJ 07002
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
EGLOFF, MARY ANN (RN)
1100 KELLY LANE
FRMINGDALE, NJ 07727
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/19/2005 |
|
EICHHORN II, WARREN THOMAS (DC)
22 FALCOLN DRIVE
VINCETOWN, NJ 08088
NPI-1326412297 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2024 |
|
EICHHORN, WARREN (DC)
447 NEW ROAD
SOUTHAMPTON, NJ 08088
NPI-1326412297 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/28/2019 |
|
EIDMAN, STEVEN (DDS)
73 E. LINCOLN AVE.
ENGLEWOOD, NJ 07631
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
1/19/2003 |
|
EISEMANN, OSHER
345 OAK STREET
LAKEWOOD, NJ 08701
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/23/2018 |
10/25/2024 |
EJIOFOR, UDOKA (RN/APN)
47 KENMORE AVENUE
NEWARK, NJ 07106
NPI-1295096584/1982024790 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/26/2018 |
10/20/2020 |
EKSTEROWICZ, DEBORAH (LPN)
283 S. BLACKHORSE PIKE
MOUNT EMPHRAIM, NJ 08059
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/18/2002 |
|
EL SOURY, AHMED #70613-050 (MD)
FCI FORT DIX, PO BOX 2000
JOINT BASE MDL, NJ 08640
NPI-1497745905 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/4/2018 |
|
ELAMIR, MADGY (MD)
14 HIGH MEADOW ROAD N
SADDLE RIVER, NJ 07458
NPI-1710081336 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/18/2015 |
|
ELAMIR, MAGDY (MD)
550 SUMMIT AVENUE
JERSEY CITY, NJ 07306
NPI-1710081336 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/5/2010 |
|
ELBASHIR, IMAD MAHGOUB
P.O. BOX 7450
TRENTON, NJ 08628
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/17/2004 |
|
ELBASHIR, IMAD MAHGOUB
160 ALABAMA AVENUE
PATERSON, NJ 07505
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
1/28/2001 |
|
ITPL DIAGNOSTIC LAB, INC./READY CARE CORPORATION
470 CHAMBERLAIN AVENUE
PATERSON, NJ 07522ELCHAGEA, ISMAIL
470 CHAMBERLAIN AVE
PATERSON, NJ 07522
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/1/2000 |
|
ELHAG, ABUBAKER O.
10 HILL STREET APT. 9W
NEWARK, NJ 07102
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/23/2007 |
|
ELHAWARY, HEBA ZAKY (CHHA)
51 SMITHFIELD DRIVE
SPRINGFIELD, NJ 07081
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/28/2024 |
|
ELIA, HARRY R. (DC)
136 BROADWAY
WESTWOOD, NJ 07675
NPI-1104034578 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
ELIA-RAGGIO, LORI (LPN)
4001 BURRYPORT WAY
MOUNT LAUREL, NJ 08054
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/18/2004 |
|
ELIAS, AHDI I (MD)
1042 MORRIS TPKE
SHORT HILLS , NJ 07078
NPI-1700808219 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/29/2022 |
Permanent |
ELLIEN, WILLIAM (MD)
39 CABBAGE XING
SAVANNAH, GA 31411
NPI-1437196375 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
ELLIOTT, CLAUDIA (CHHA)
345 PARK AVENUE, APT. 4
PATERSON, NJ 07504
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/26/2017 |
|
ELLIOTT, ROISIN M. (LPN)
115 S MAHWAH ROAD
MAHWAH, NJ 07430
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/18/2022 |
|
ELLIS, JAMES (MD)
763 GLENWILD DRIVE
CANTON, MS 39046
NPI-1578566733 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/11/2021 |
|
ELLIS, KENT R. (MD)
1005 N. WASHINGTON AVE
GREEN BROOK, NJ 08812
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/15/2001 |
Permanent |
ELLIS, MICHAEL
FENWICK HOUSE 367-371 MARKET STREET
PATERSON, NJ 07501
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2024 |
|
ELLIS, MICHAEL A.
33 FERRIS LANE
OAK RIDGE, NJ 07438
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/1/2024 |
|
ELLISON, RAEFORD (LAC)
8 N. SACRAMENTO AVENUE
VENTNOR, NJ 08406
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/18/2002 |
|
ELSAYED, ABEER (CHHA)
290 GETTY AVENUE, FLOOR 2
PATERSON, NJ 07503
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/28/2023 |
|
ELYAS, EVON (CHHA)
14 CROSSGATE ROAD, APT. B
JERSEY CITY, NJ 07305
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/28/2023 |
|
EMERICK, KRISTY M. (RN)
74 16TH STREET
TOMS RIVER, NJ 08753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/14/2024 |
|
EMERSON, BARBARA L. (RN)
45 HAWTHORNE ST.
BROWNS MILLS, NJ 08015
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2004 |
|
REFOCUS GROUP LLC
200 ROUND HILL DRIVE
FREEHOLD, NJ 07728EMMERICH, MICHELE
200 ROUND HILL DRIVE
FREEHOLD, NJ 07728
NPI-1306342373 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
4/29/2019 |
|
ENEMUO, JOHNNY
215 JACOBY ST., 1ST FLOOR
MAPLEWOOD, NJ 07040
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/1/1999 |
Permanent |
ENEMUO, KENNETH (RPH )
236-242 S. ORANGE AVENUE
NEWARK, NJ 07103
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/1999 |
10/26/2017 |
ENGRISSEI, PATRICIA LEISE (RN)
700 GROVE STREET
HADDONFIELD, NJ 08033
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/18/2005 |
|
FAMILY CARE PHARMACY
456 BERGEN AVENUE
JERSEY CITY, NJ 07304ENOGWE, FELIX (RPH)
51 CLIFTON AVE., C-401
NEWARK, NJ 07104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/24/1999 |
Permanent |
ENOGWE, FELIX (RPH)
25 CLIFTON AVENUE
NEWARK, NJ 07104
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/24/2006 |
|
ENRICO JR., ANTHONY (DPM)
57 STONEYRIDGE DRIVE
LINCOLN PARK, NJ 07035
NPI-1013095975 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2017 |
|
ENRICO JR., ANTHONY (DPM)
99 SUNCREST AVENUE
NORTH HALEDON, NJ 07508
NPI-1013095975 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
ENRICO JR., ANTHONY #71171-050 (DPM)
USP LEWISBURG, PO BOX 1000
LEWISBURG, PA 17837
NPI-1013095975 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/5/2019 |
|
EPHIRAM, EMMANUEL K. a/k/a EMMANUEL QUAYE (CHHA)
84 WINDING WOOD DRIVE, APT 2B
SAYREVILLE, NJ 08872
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/25/2025 |
|
ERIKSON, LISA L. a/k/a LISA STAVELY (LPN)
75 BEAVER AVENUE
WHITING, NJ 08759
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/14/2025 |
|
ERKOBONI, PATRICIA (RN)
1850 W. MCGALLIARD AVENUE
TRENTON, NJ 08610
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/14/2018 |
|
ERNST, DAVID J. (DDS)
5 BRUNSWICK WOOD DRIVE
E. BRUNSWICK, NJ 08816
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/31/1995 |
Permanent |
ESCALERA, EMILY (CHHA)
3716 UNION AVENUE, APT. B
PENNSAUKEN, NJ 08109
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/2/2018 |
|
ESHAM, CHARLES (MD)
2401 GREENLEAF DRIVE
WILMINGTON, DE 19810
NPI-1457315921 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/15/2021 |
|
ESPADA, MARGARET (CHHA)
310 HAMILTON AVENUE
SEASIDE HEIGHTS, NJ 08751
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
ESPINDOLA, JUAN (MD)
467 CLIFTON AVENUE
CLIFTON, NJ 07011
NPI-1881703726 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/29/2016 |
4/1/2017 |
ESPINDOLA, JUAN (MD)
32 FOREST STREET
MONTCLAIR, NJ 07042
NPI-1881703726/1225238074 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/1/2017 |
|
ESPOSITO, VINCENT (MD)
5 BUCKINGHAM DRIVE
MADISON, NJ 07940
NPI-1225008253 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2017 |
|
ESQUERRE, RENE (MD)
5 ASHLEY ROAD
WEST ORANGE, NJ 07052
NPI-1033150172 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/18/2018 |
11/8/2018 |
ESSER, ARISTIDE HENRI (PSY)
337 N. MAIN STREET, STE 2
NEW CITY, NY 10956
NPI-1447249891 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2013 |
|
ESTAMBUL, BERNARDO
605 W.141 STREET, APT 51
NEW YORK, NY 10031
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/31/2008 |
|
ESTERMAN, SIDNEY (DPM)
185 CENTRAL AVE, STE. 412
EAST ORANGE, NJ
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/31/2001 |
Permanent |
ETIENNE, FERNANDE (CHHA)
1205 MORRIS STREET #2L
ROSELLE, NJ 07203
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/20/2006 |
|
EUSEBIO, EDWIN (CHHA)
220 S. 30TH STREET
CAMDEN, NJ 08105
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
EVANS JR., EUGENE (MD)
301 E. LINCOLN AVENUE
ROSELLE PARK, NJ 07204
NPI-1033284930 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/9/2017 |
|
EVANS, ROLAND A. (DC)
263 NORTH 3RD AVE.
MANVILLE, NJ 08835
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/3/2003 |
|
EVDOKIMOW, DAVID (MD)
96 S. FINLEY AVENUE
BASKING RIDGE, NJ 07920
NPI-1508930678 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/12/2018 |
|
EVERS, MARTIN L. (MD)
FCI DANBURY, ROUTE 37
DANBURY, CT 06811
NPI-1366434110 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2024 |
|
EVRA, JOANEL (CHHA)
1551B ASBURY AVENUE
ASBURY PARK, NJ 07712
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/29/2017 |
|
EWING, DIONNA (CHHA)
909 HADDON AVENUE
CAMDEN, NJ 08103
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/2/2018 |
|
EZELL, PAUL (MD)
251 SAGEMORE ROAD
HAVERTOWN, PA 19083
NPI-1235130741 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
EZEONYIM, CHARLES I. (RPH)
2153 TYLER STREET
UNION, NJ 07083
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/16/2009 |
1/6/2012 |
EZINWA, JENNIFER (CHHA)
509 COVENTRY LANE, APT. 210
SALIBURY, MD 21804
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/28/2023 |
|
FABULIAN, PETER (DO)
26 WEST MAIN STREET
STRASBURG, PA 17579
NPI-1023184835 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2013 |
|
FAENZA, MATTHEW (RPH)
64 COVENTRY WAY
RINGWOOD, NJ 07456
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/20/2004 |
|
FAERMAN, VLADIMIR (CHHA)
2506 GATES COURT
MORRIS PLAINS, NJ 07950
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/16/2017 |
|
FAHE, MIREILLE (RN)
269 MAIN STREET, APT. B
NEW MILFORD, NJ 07646
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/3/2017 |
10/24/2018 |
FAISON, LAUREN
1804 EAST THAYER STREET
PHILADEPHIA, PA 19134
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
FAKONDO, VICTOR
180 HANSON AVE
PISCATAWAY, NJ 08854
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/18/2011 |
|
FALLAH, KEBEH (CHHA)
365 SCHLEY STREET, APT. A8
NEWARK, NJ 07112
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/14/2017 |
6/12/2018 |
FALLUCCA, KARLA JANE (APN/RN)
21 STONEHAM DRIVE
DELRAN, NJ 08075
NPI-1053734095 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/20/2020 |
3/28/2024 |
FALOWO, YETUNDE
301 MAPLE AVE., APT266
N. PLAINFIELD, NJ 07060
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/6/2006 |
|
FARL. MUTALIB (CHHA)
61 NORTH ARLINGTON AVENUE
EAST ORANGE, NJ 07017
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/3/2018 |
|
FARRIS, JOEL (CHHA)
212 UNION AVENUE
NEPTUNE, NJ 07753
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2001 |
|
FARRO, ANDREW
87 CASTLE RIDGE DRIVE
EAST HANOVER, NJ 07936
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/12/2008 |
|
FASANO, JUDITH (RN)
1770 YORKTOWNE BOULEVARD
TOMS RIVER, NJ 08753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/5/2017 |
|
FASONU, AYODEJI
70 RUSLING PLACE
BRIDGEPORT, CT 06604
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/7/2023 |
|
FASWALA, MUNIR H. (MD)
506 LAGOON BLVD.
BRIGANTINE, NJ 08203
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/15/2008 |
|
FASWALA, MUNIR H. (MD)
506 LAGOON BLVD.
BRIGANTINE, NJ 08203
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/26/2005 |
|
FATATO, VIRGINIA A. (DC)
8 N. WHITEHORSE PIKE
HAMMONTON, NJ 08009
NPI-1437432960 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
5/5/2003 |
|
FAULX, LORI (RN)
4444 N. 7TH AVENUE, APT. 417
PHOENIX, AZ 85013
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
FAUSTINO, ALAN (MD)
110 WEST CHURCH STREET
ABSECON, NJ 08201
NPI-1669482568 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/29/2016 |
3/8/2019 |
FAUSTINO, ALAN (MD)
28 W. GILMAR CIRCLE
MARGATE CITY, NJ 08402
NPI-1669482568 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/8/2019 |
Permanent |
FAUSTINO, ALAN (MD)
830 PLYMOUTH PLACE, UNIT 2
OCEAN CITY, NJ 08226
NPI-1669482568 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/3/2019 |
|
FAZZINI JR., ROBERT PHILLIP
27 HAWTHORN DRIVE, SUITE 2
SUCCASUNNA, NJ 07876
NPI-1962771923 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2024 |
|
FEAST, SHALITHA L. (LPN)
31 FLINTLOCK DRIVE
HOWELL, NJ 07731
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/14/2025 |
|
FEE, CATHERINE ANN (RPH)
7353 CLUBHOUSE CIRCLE
EGG HARBOR CITY, NJ 08215
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/19/2006 |
8/30/2022 |
FEELEY, JAMES
1036 GLENDALOUGH DRIVE
GRAFTON, OH 44044
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/14/2024 |
|
FEIGIN, LESLIE C. (MD)
160 POWDER MILL ROAD
MORRIS PLAINS, NJ 07950
NPI-1447336250 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/25/2022 |
Permanent |
FEINBERG, IRA
411 CHELSEA STREET
PARAMUS, NJ 07652
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
FEINMAN, BRIAN (DPM)
418 WALNUT STREET
NEWARK, NJ 07105
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/20/2006 |
Permanent |
FEIT, FREDRIC (MD)
2 TWIN LAKES DRIVE
MANALAPAN, NJ 07726
NPI-1093835308 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
7/13/2009 |
|
FELDMAN, BRUCE J.
807 NORTHWINDS DRIVE
BRYN MAWR, PA 19010
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/18/2004 |
|
FELDMON, DORON (MD)
FCI MCKEAN, PO 8000
BRADFORD, PA 16702
NPI-1194704627 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2015 |
|
FELDNER, EDWARD S. (MD)
50 E MAIN STREET
LITTLE FALLS, NJ 07424
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/16/1999 |
DECEASED |
FELIX, JESSICA (CHHA)
40 PASSAIC STREET, APT. 4D
HACKENSACK, NJ 07601
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/14/2015 |
|
FELLUS, JONATHAN L. (MD)
57 WOODLAND AVENUE
GLEN RIDGE, NJ 07028
NPI-1053309195 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2015 |
5/21/2020 |
FELLUS, JONATHAN L. (MD)
45 WILFRED STREET, APT. 8
WEST ORANGE, NJ 07052
NPI-1053309195 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/26/2026 |
|
FELSENBERG, SANFORD
517 SO ORANGE AVENUE
NEWARK, NJ 07103
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
FERMIN, ESPERANZA (CHHA)
229 MADISON AVENUE, APT. #1
PATERSON, NJ 07524
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
FERNANDEZ, LUIS (DPM)
293 MONROE STREET
PASSAIC, NJ 07055
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
3/26/1997 |
Permanent |
FERRANDINO, LUIGI (MD)
8 EAST RAMAPO AVENUE
MAHWAH, NJ 07430
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2007 |
Permanent |
FERRARI, FRANCIS M. (DPM)
482 KEARNEY AVENUE
KEARNY, NJ 07032
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/16/1995 |
Permanent |
FERRARO, LISA (MD)
414 BROADWAY
PATERSON, NJ 07501
NPI-1659302925 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/25/2025 |
|
FERRINGO, MICHAEL J.
616 GLEN COURT
TURNERSVILLE, NJ 08012
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/20/2012 |
4/12/2022 |
FERSTANDIG, RUSSELL A. (MD)
179 MAPLE AVE.
RIDGEWOOD, NJ 07450
NPI-1780779702 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/7/1987 |
1/1/2013 |
FIELDS, CARENE (CHHA)
190 HAMILTON AVENUE, APT. #8
PATERSON, NJ 07501
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
FIGUEREO, ESTHER J. (RN)
83 CLIFTON AVENUE
CLIFTON, NJ 07011
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2024 |
|
FIGUEROA, DESIREE (CHHA)
11 COLLETON STREET
LAKEWOOD, NJ 08701
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
FIGUEROA, JORGE (MD)
493 21ST AVENUE
PATERSON, NJ 07513
NPI-1770542151 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/23/2018 |
|
FIGUEROA, JORGE (MD)
USP LEWISBURG, PO BOX 1000
LEWISBURG, PA 17837
NPI-1770542151 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/19/2018 |
|
FILIPONE JR., DENNIS R. (MD)
147 STANTON ROAD
FLEMINGTON, NJ 08822
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/21/1998 |
Permanent |
FILIPPONE, MARK A.P. (MD)
15 MORRISSEE AVENUE
WALLINGTON, NJ 07057
NPI-1710063797 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/18/2021 |
|
FINDER, RICHARD (DC)
810 ABBOTT BLVD.
FORT LEE, NJ 07024
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
5/1/2004 |
|
FINE, EDWARD (MD)
271 MOORE LANE
HADDONFIELD, NJ 08033
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/28/1983 |
Permanent |
FINELLI, PETER K (DO)
919 MAIN STREET
BELMAR, NJ 07719
NPI-1427067156 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/15/2022 |
Permanent |
FINESMITH, ROSS (MD)
PARKVIEW AVENUE
BASKING RIDGE, NJ 07920
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/10/2007 |
Permanent |
FINK, DAVID (PSYCH)
139 HIGHLAND AVENUE
METUCHEN, NJ 08840
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2003 |
|
FINKEL, MARINA
EDNA MAHAN CORRECTIIONAL
CLINTON, NJ 08809
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/15/2014 |
|
FINKEL, MARINA
75 STONEGATE DRIVE
STATEN ISLAND, NY 10304
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/3/2013 |
|
FIRLEIN, BRYAN
118 FERNSHIRE COURT
WENONAH, NJ 08090
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/25/2025 |
|
FISCHBERG, JUAN C. (MD)
354 RUSSELL AVENUE
EDGEWATER, NJ 07020
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/19/2008 |
|
FISCHGRUND, JOEL (MD)
56 CORNELL DRIVE
LIVINGSTON, NJ 07039
NPI-1427097534 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/30/2014 |
|
FISCHGRUND, JOEL (MD)
56 CORNELL DRIVE
LIVINGSTON, NJ 07039
NPI-1427097534 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/24/2017 |
|
FISCHMAN, HAROLD (MD)
56 BOWDOIN ST
MAPLEWOOD, NJ 07040
NPI- |
Medical
Industry Law Violation |
Disqualification Law and Public Safety
Consumer Affairs Board of Medical Examiners |
6/1/1993 |
Permanent |
FISH, MICHAEL (DMD)
1500 PINE PARK AVENUE
LAKEWOOD, NJ 08701
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/20/2007 |
7/17/2013 |
FISHER, CALLETTA (PHARM TECH)
115 SENACA BOULEVARD
BARNEGAT, NJ 08005
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/21/2016 |
|
FISHER, DARRYL
55 SHELBOURNE STREET
BURLINGTON, NJ 08016
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/6/2006 |
7/24/2023 |
FISHER, WILLIAM (LPN)
12 ROBERTA DRIVE
NEPTUNE, NJ 07753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/9/2025 |
|
FISHER-FENNELL, LASHEA (LPN)
18 6TH STREET
SAYREVILLE, NJ 08872
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/29/2025 |
|
FITZPATRICK, TIA LYNETTE (LPN)
4 PERSIA COURT
SICKLERVILLE, NJ 08081
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/4/2022 |
|
FLANNERY, PATRICIA
2023 LEITHSVILLE ROAD
HELLERTOWN, PA 18055
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2023 |
|
FLEISCHER, MARK H. (MD)
FCI-OTISVILLE, PO BOX 600
OTISVILLE, NY 10963
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/20/2005 |
|
FLEISCHMAN, EDWARD (DO)
3804 CHURCH ROAD
MOUNT HOLLY, NJ 08054
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
8/25/1998 |
|
FLEMING, KEVIN M. (MD)
710 STATION AVENUE 2 FLR
HADDON HEIGHTS, NJ 08035
NPI-1508816075 |
Medical
Contingent Fees |
Suspension Human Services
Medical Assistance (Medicaid) |
11/20/2010 |
|
FLEMING, STEPHANIE LYNN
FCI DANBURY ROUTE 37
DANBURY, CT 06811
NPI-1073819934 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/2023 |
|
FLEURANTIN, MARIE (RN)
14 OAK TREE COURT
WESTAMPTON, NJ 08060
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/24/2018 |
|
FLEURANTIN, RUBEN J.
SCOTLAND ROAD
SO. ORANGE, NJ 07079
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/20/2008 |
|
FLEURY, DIANE (RN)
552 PENNY STREET
FRANKLINVILLE, NJ 08322
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2001 |
|
FLEYSHMAKHER, ALEX
211 WALNUT DRIVE
MORGANVILLE, NJ 07751
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/6/2024 |
|
FLEYSHMAKHER, IGOR
26 WINCHESTER LANE
HOLMDEL, NJ 07733
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/19/2023 |
|
FLORES, CARMEN (CHHA)
95 PROSPECT STREET, APT. #1
PASSAIC, NJ 07055
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/6/2018 |
|
FLORES, MARIE MIRAVITE (RN)
258 DEEP BROOK COURT
PISCATAWAY, NJ 08854
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/20/2004 |
|
FLORES, MARITZA
1097 EAGLEHURST ROAD
TOMS RIVER, NJ 08753
NPI- |
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/26/2024 |
|
FLORES, MELBA (CHHA)
106 MAPLE AVENUE
BOONTON, NJ 07005
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
FLOUNDERS, JOSEPH P. (LPN)
106 W. MIAMI AVE.
VILLAS, NJ 08251
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2005 |
|
FLOWERS JR., HERMAN J. (CHHA)
143 URSINUS COURT
PEMBERTON, NJ 08075
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/10/1997 |
Permanent |
FLOWERS, FELICIA (CHHA)
321 NEPTUNE BOULEVARD
NEPTUNE, NJ 07753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/14/2017 |
9/5/2023 |
FLOWERS, HERMAN T.
143 URSINUS COURT
PEMBERTON, NJ 08075
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/16/1999 |
|
FLOYD, JAMES A. (PHD)
1733 BLAKE BOTTOM ROAD NW
HUNTSVILLE, AL 35806
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/26/2010 |
|
FOGLER, SEAN (MD)
1900 HAMILTON STREET
PHILADELPHIA, PA 19130
NPI-1548322068 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/28/2017 |
|
FOGLER, SEAN (MD)
201 N. 8TH STREET, UNIT 911
PHILADELPHIA, PA 17105
NPI-1548322068 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2019 |
|
FOLK, THOMASA A.
463 IRVINGTON AVENUE
ELIZABETH, NJ 07201
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/19/2006 |
|
FOLKERTS, ANNAMARIA M. (MD)
32 OAK PLACE
HAWTHORNE, NJ 07506
NPI- |
Medical
Industry Law Violation |
Disqualification Law and Public Safety
Medical Assistance (Medicaid) |
12/8/1993 |
Permanent |
FONTANELLA, DANIEL (DC)
27 MOUNTAINWOOD COURT
TOTOWA, NJ 07512
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/20/2003 |
|
FONTANEZ, MODESTO (MD)
1838 2ND AVENUE
NEW YORK, NY 10128
NPI-1851395826 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/7/2011 |
|
FOOTE, JESSE
FCI OTISVILLE, PO BOX 1000
OTISVILLE, NY 10963
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/18/2026 |
|
FORBES, AASE (RN)
882 DEWEY STREET
UNION, NJ 07083
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/20/2009 |
|
FORD, MARYKATE (RN)
103 SWEETWATER DRIVE
CINNAMINSON, NJ 08077
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/30/2018 |
|
FORD, TAMIKA (CHHA)
600 ELM STREET
CAMDEN, NJ 08102
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
FORDE, SHIVONNE
57 CHESTNUT STREET C4
EAST ORANGE, NJ 07018
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/8/2010 |
3/8/2015 |
FORMAN, STEVEN (DPM)
15 CANTERBURY PLACE
SICKLERVILLE, NJ 08081
NPI-1700850096 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/18/2017 |
|
FORMICOLA, JENNIFER L (CSW)
1282 S COLUMBINE STREET
DENVER, CO 80210
NPI-1174163026 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2022 |
|
FORNEY, DONALD
354 CRESCENT STREET
HARRISBURG, PA 17104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
FORSHAY, LAUREN (RN)
2201 RIVER ROAD
PT. PLEASANT BORO, NJ 08742
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/25/2016 |
6/26/2017 |
FORTI, PAUL J. (PSYCH)
6 SILVER SPRING COURT
EAST HANOVER, NJ 07936
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2001 |
Permanent |
FORTUNATO, FRANKLIN (MD)
FMC-DEVENS, PO BOX 879
AYERS, MA 01432
NPI-1548278930 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/11/2016 |
|
FORTUNATO, FRANKLIN D. (MD)
127 PINE STREET
MONTCLAIR, NJ 07042
NPI-1548278930 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/29/2015 |
|
FOSTER, DEBRA (CHHA)
714 ZLOTKIN CIRLCE, APT. 6
FREEHOLD, NJ 07728
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/18/2017 |
|
FOWLER, BERNARD J. (MD)
1341 MIDDLE GULF DRIVE 12D
SANIBEL, FL 33957
NPI-1326105032 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2015 |
|
FOWLER, BERNARD J. (MD)
15 GRIST MILL RUN
MAHWAH, NJ 07430
NPI-1326105032 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/27/2014 |
|
FOX, SUSAN (DMD)
2300 WALNUT STREET
PHILADEPHIA, PA 19103
NPI-1952661472 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2015 |
|
FRAENKEL, DAVID M. (DDS)
BERGEN MALL DENTAL OFFICE
PARAMUS, NJ 07652
NPI-1790774271 |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/4/1991 |
4/5/2018 |
FRANCILLON, CARLINE (LPN)
98 ASHLAND ACENUE, 2ND FLOOR
WEST ORANGE, NJ 07052
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/13/2017 |
7/27/2022 |
FRANCISCO, DALMACIO HONASAN (MD)
9303 90TH AVENUE, 1ST FLOOR
WOODHAVEN, NY 11421
NPI-1922084763 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
10/19/2023 |
|
FRANCO, DAISY (CHHA)
URB JARDIN DE S. ANNA
COAMO, NJ 00769
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/10/2007 |
Permanent |
FRANCOIS, EMMANUEL (MD)
187 HOBART GAP ROAD
LIVINGSTON, NJ 07039
NPI-1457383382 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/10/2016 |
7/19/2019 |
FRANCOIS, ESTHER (CHHA)
514 LIDGERWOOD AVENUE
ELIZABETH, NJ 07202
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/17/2018 |
8/30/2023 |
FRANK, OLEG (MD)
40 FERRY STREET
NEWARK, NJ 07105
NPI-1457469090 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
9/9/2016 |
2/7/2020 |
FRANKLIN, ANGELICA TUCKER (RN)
8006 LOWWIN TERRACE
CHESTERFIELD, VA 23832
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/18/2023 |
|
FRANKLIN, KRISTY MARIE (RN)
12 UTILITY WAY #371
OTISVILLE, NY 10963
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2025 |
|
FRARE, ROBERT (DMD)
15 PROMENADE PLACE
VOORHEES, NJ 08043
NPI-1740477553 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/29/2014 |
Permanent |
FRASCA, CLIFFORD C.
637 WESTON DRIVE
TOMS RIVER, NJ 08755
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/8/1999 |
Permanent |
FRASER, KEITH (MD)
6 WEDGEWOOD DRIVE, UNIT7
VERONA, NJ 07044
NPI-1881621266 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/10/2011 |
12/4/2014 |
FRASER, SHAWN E.
P.O. BOX 7000
FORT DIX, NJ 08640
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2005 |
|
FREDERICK, KIMBERLY M. (RN)
78 BOUNDARY AVENUE
HANOVER, PA 17331
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/12/2008 |
|
FREE, KEVIN R. (MD)
14 PATTEN TERRACE
CEDAR GROVE, NJ 07009
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/14/1998 |
Permanent |
FREILER, JOHN (DMD)
2307 WARRENS WAY
WANAQUE, NJ 07465
NPI-1295815710 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/26/2018 |
|
FREMPONG, EBENEZER (CHHA)
30 POST STREET, APT. 6M
YONKERS, NY 10705
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/2/2018 |
|
FRENCH, EUGENE (MD)
241 SUMMIT AVENUE
HACKENSACK, NJ 07601
NPI-1215927843 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/18/2016 |
|
FRICK, JAEMS
1626 ABBOT AVENUE
TOMS RIVER, NJ 08753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/5/2004 |
|
FRIDMAN, LEV (CHHA)
6 SALT MEADOW ROAD
EAST BRUNSWICK, NJ 08816
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/2/2017 |
|
FRIED, MARTIN (MD)
5 SHINNECOCK HILLS DRIVE
ASBURY PARK, NJ 07712
NPI-1407087802 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/17/2018 |
|
FRIED, MARTIN (MD)
5 SHINNECOCK HILLS DRIVE
ASBURY PARK, NJ 07712
NPI-1407087802 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/21/2019 |
|
FRIEDMAN, AMIR (MD)
390 N. BROADWAY, STE 1000
PENNSVILLE, NJ 08070
NPI-1417907361 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/1/2014 |
8/11/2016 |
FRIEDMAN, AMIR (MD)
6928 PESCADO CIRCLE #5
RANCHO MURIETA, CA 95683
NPI-1689662041 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/15/2022 |
|
FRIEDMAN, LAWRENCE A. OWNER
1688-90 54TH STREET
BROOKLYN, NY 11024
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/16/2002 |
|
FRIEDMAN, SHERRY (RN)
12 HOPI TRAIL
OAK RIDGE, NJ 07348
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2003 |
|
FRIEND, CHARLES (LPN)
2336 CORBETT RD
PENNSAUKEN, NJ 08109
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/19/2003 |
|
FRIMPONG, JOSEPH (CHHA)
357-363 LINCOLN AVENUE, APT. 3D
ORANGE, NJ 07050
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
FRIMPONG, KOFI (LPN/RN)
ESSEX ROAD
MAPLEWOOD, NJ 07040
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/20/2007 |
|
FRISCH, FREDERICK (MD)
7 SOUTH DUDLEY AVE.
VENTOR, NJ 08406
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/5/1994 |
DECEASED |
FRITTS, LARRY F. (RN)
5 AUTUMN RIDGE LANE
PHILLIPSBURG, NJ 08865
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2005 |
|
FRITZ, GINA (LPN)
52718-2 PIMA COURT
KILEEN, TX 76543
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/14/2018 |
|
FROHWIRTH, DANIEL H. (MD)
MEADOW RD P O BOX 274
WHITEHOUSE, NJ 08888
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/18/1992 |
Permanent |
FROMER, CARL H. (MD)
1000 CLOVER ROAD, APT 7R
STATEN ISLAND, NY 10314
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/20/2000 |
Permanent |
FROMM, JOSEPH MICHAEL
28301 ATLANTIC AVE.#110 S
ATLANTIC CITY, NJ 08401
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/17/1991 |
Permanent |
FROSCH, LISA AKA PLOTTS, LISA (RN)
111 BEECHWOOD AVENUE
OAKLYN, NJ 08107
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/18/2001 |
4/5/2022 |
FRYE, ROBIN (CHHA)
1224 WASHINGTON AVENUE
CAMDEN, NJ 08104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/13/2018 |
Permanent |
FRYER, CYNTHIA (LPN)
PO BOX 121
MERRY HILL, NC 27957
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2017 |
|
FUKUCHI, STEVEN G. (MD)
236 STAMPER STREET
PHILADELPHIA, PA 19147
NPI-1902875990 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/13/2025 |
|
FURLONG, KELLY AKA COPPOLA, KELLY (PHARM TECH)
52 CORNELL DRIVE
HAZLET, NJ 07730
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/23/2016 |
|
GABER, ROBERT A. (DDS)
100 VAIL ROAD
PARSIPPANY, NJ 07054
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/19/1988 |
Permanent |
GABRIEL, NWALA (RPH)
34 SCHOOL STREET
PISCATAWAY, NJ 08854
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/23/2010 |
|
GADHOK, RAJINDER S.
120 CIRCEL AVE., BOX 121
BERKELY HGHTS, NJ 07922
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/12/1997 |
Permanent |
GADIRAJU, SRINIVAS (RPH)
76 MORRIS STREET
MORRISTOWN, NJ 07960
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/2023 |
|
GAFFNEY, JOHN (DO)
9501 VENTNOR AVENUE
MARGATE CITY, NJ 08402
NPI-1710985387 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/24/2017 |
|
GAINER, JAHNIA (PHARM TECH)
11 14TH AVENUE
NEWARK, NJ 07103
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/26/2016 |
2/12/2024 |
GAINES, TONI
4650 COLES MILL ROAD R-3
WILLIAMSTOWN, NJ 08094
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/4/2012 |
8/3/2014 |
GAITHER, HERBERT (MD)
1453 HILLCREST COURT, APT. 407
CAMP HILL, PA 17011
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
GALCIK, DIANE (LPN)
34 MAHAN STREET
TENAFLY, NJ 07670
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2001 |
|
GALIN, MILES A. (MD)
EAST END AVENUE
NEW YORK, NY 10128
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
9/19/2008 |
|
GALINSKY, KIMBERLY (RPH)
220 VAN FLEET AVENUE
SOUTH PLAINFIELD, NJ 07080
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/10/2017 |
|
GALINSKY, RONALD C. (PSYCH)
34 DUNHILL DRIVE
VOORHEES, NJ 08043
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
GALL, WILLIAM J. (DO)
22 STONEGATE COURT
BLACKWOOD, NJ 08012
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2009 |
Permanent |
GALLAGHER JR., WALTER B. (RN)
132 TULIP LANE
SUMMIT, NJ 07901
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2005 |
|
GALLAGHER, BRENDA JO (RN/LPN)
14B WISHING WELL ROAD
HAMBURG, NJ 07419
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/19/2001 |
|
GALLAGHER, CORNELIUS T. (MD)
1411 WINESAP DRIVE
MANASQUAN, NJ 08736
NPI-1194727982 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2025 |
|
GALLAGHER, JOANNE M. (DC)
108 BENJAMIN AVENUE
CONYNGHAM, PA 18219
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2005 |
|
GALLAGHER, PATRICIA A. (RN)
111 QUAKER ROAD
MICKLETON, NJ 08056
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2014 |
|
GALLE, JAMES (RPH)
105 ELM AVENUE
HACKENSACK, NJ 07644
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/16/2003 |
|
GALLETTA, ERNEST
FCI FAIRTON P.O. BOX 420
FAIRTON, NJ 08320
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/19/2009 |
|
GALLETTA, GEORGE W.
3001 E. CHESTNUT AVE A1
VINELAND, NJ 08361
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/19/2009 |
|
GAMAO, EDDIE (MD)
375 NORTH DRIVE, J9
NORTH PLAINFIELD, NJ 07060
NPI-1639479397/1770500423 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/14/2018 |
|
GAMAO, EDDIE (MD)
375 NORTH DRIVE, J9
NORTH PLAINFIELD, NJ 07060
NPI-1639479397/1770500423 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/31/2018 |
Permanent |
GAMUZZA, VINCENT #70500-050 (OPTOMETRIST)
FCI FORT DIX, PO BOX 2000
JOINT BASE MDL, NJ 08640
NPI-1063851285 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2018 |
|
GANDHI, HIREN
120 ROLLING BROOK DRIVE
EDISON, NJ 08820
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2005 |
|
GANETSKY, SVETLANA (PT)
197 SOUTH EDWARDS DRIVE
SOUTHAMPTON, PA 18966
NPI-1407180037 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
GANTI, SHASHI (MD)
2035 HAMBURG PIKE
WAYNE, NJ 07410
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/1997 |
3/3/2020 |
GARCEN, GINA AKA CIALLELLA, GINA (DC)
57 GREEN STREET
WOODBRIDGE, NJ 07095
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/24/2000 |
Permanent |
GARCIA, DIANE (LCSW)
6612 TERRA DOLCE AVE NW
ALBUQUERQUE, NM 87114
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/18/2012 |
|
GARCIA, SHEILA (CHHA)
1003 W. CHAPLAIN ROAD
MANVILLE, NJ 08835
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2017 |
|
GARDINER, MICHAEL A. (DC)
2066 MILBURN AVENUE
MAPLEWOOD, NJ 07040
NPI-1346524907 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
2/3/2003 |
|
GARIPALLI, LAXMIPATHI (MD)
11 COLTS GAIT LANE
COLTS NECK, NJ 07722
NPI-1851325500 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/21/2008 |
|
GARIPALLI, LAXMIPATHI (MD)
11 COLTS GAIT LANE
COLTS NECK, NJ 07722
NPI-1851325500 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2012 |
|
GARRETSON, MATTHEW (PHARM TECH)
119 GLEN AVENUE
LAKEWOOD, NJ 08701
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/23/2016 |
|
GARRITANO, RALPH E. (MD)
281 GROVE ST
ORADELL, NJ 07649
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
GAULT, TYMIER (CHHA)
180 HAYNES AVENUE
BRIDGETON, NJ 08302
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/22/2017 |
|
GAYLE, DELORES (MD)
249 GREGORY AVENUE
WEST ORANGE, NJ 07052
NPI-1508886664 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/16/2015 |
6/5/2017 |
GAYLE, DELORES (MD)
249 GREGORY AVENUE
WEST ORANGE, NJ 07052
NPI-1508886664 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/5/2017 |
Permanent |
GAYLE, LURINE (CHHA)
2144 ALDRIN ROAD, #5A
OCEAN, NJ 07712
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
1/15/2025 |
GAZI, MUKARAM (MD)
9 EMBRY FARM RD
MARLBORO, NJ 07746
NPI-1679527188 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
7/25/2023 |
5/27/2025 |
GECYS, GINTARE T. (DO)
1504 BLACKWOOD CLEMENTON
BLACKWOOD, NJ 08012
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/22/2015 |
5/21/2020 |
GEFFEN, STEVEN
50 SKYLARK COURT
MARLBORO, NJ 07746
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/15/2000 |
Permanent |
GENNINGER, LEWIS E. (MD)
95 SOUTH MAIN ST
PHILLIPSBURG, NJ 08865
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/10/1988 |
DECEASED |
GENSHEIMER, MAUREEN (LPN)
1409 EDGEMERE ROAD
WALL, NJ 07719
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2002 |
|
GEORGE, JOBY (RPH)
395 MYRTLE STREET
CLIFFWOOD, NJ 07721
NPI-1255481917 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
7/18/2011 |
2/15/2025 |
GERALDO, PHILIP K. (RN)
2075 SPRINGFIELD AVENUE, FL 2
VAUXHALL, NJ 07088
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/5/2023 |
|
GERARDO, LETRICIA M. (MD)
317 MT. PROSPECT AVE.
NEWARK, NJ 07104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/30/1997 |
Permanent |
GERMAN, MARIA (CHHA)
195 BROADWAY
PATERSON, NJ 07505
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/24/2002 |
|
GERNER, JASON
A 16 COLEBRICK COURT
SHAMONG, NJ 08088
NPI-1295191005 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/19/2023 |
|
GETSON, LEE
7 HAMILTON COURT
SOUTHAMPTON, NJ 08088
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/12/2016 |
|
GIACALONE-HEWSON, MARIA (DC)
FCI COLEMAN MEDIUM, PO BOX 1032
COLEMAN, FL 33521
NPI-1487782504 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
GIALANELLA, CRAIG (MD)
4 OXFORD ROAD
NORTH CALDWELL, NJ 07006
NPI-1467596502 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2017 |
|
GIAMPORCARO, STEVEN (MD)
15 GLEN AIRE DRIVE
EGG HARBOR TOWNSHIP, NJ 08234
NPI-1255356994 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/22/2019 |
Permanent |
INTERCONTINENTAL MEDICAL
185 BROADWAY #14
PATERSON, NJ 07505GIANETTI JR., JOSEPH P. (DC)
LINDEMAN AVENUE
CLOSTER, NJ 07624
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/18/2008 |
|
GIANNOTTO, ANTHONY (MD)
31 PALM STREET
NEWARK, NJ 07106
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/24/1988 |
Permanent |
GIARRETTA, MARY SUEANNE (RPH)
9 KINGWOOD AVE
FRENCHTOWN, NJ 08825
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/15/2001 |
Permanent |
GIBBONS, SHANIKA (CHHA)
11 LINDEN AVENUE
EDISON, NJ 08817
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
GIBBONS, SHAWN S.
40 DOVER STREET
NEWARK, NJ 07106
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/24/2007 |
|
GIBBONS, WAYNE L. (MD)
2 EAST RIVER DRIVE
WILLINGBORO, NJ 08046
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
1/12/2001 |
Permanent |
GIBBS, ARLENE (CHHA)
18 BELLEVILLE CT APT C
BELLEVILLE, NJ 07109
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/20/2007 |
|
GIBBS, ARLENE (CHHA)
35 CIVIC SQUARE, #23
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/28/2006 |
|
GIBBS, MARY ELLEN (CHHA)
157 ANDREW STREET
HAMILTON, NJ 08610
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
2/14/2002 |
|
GIBNEY, EDWARD D.
10 CEDAR LAKE
DENVILLE, NJ 07834
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
GIBSON, MARY E.
376 MADISON AVENUE
RAHWAY, NJ 07065
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/18/2001 |
Permanent |
GIFFINS-MATLACK, DEANNE (LPN)
46 BURT STREET
BRIDGETON, NJ 08302
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/28/2017 |
|
GILL, ALYSON R. (RN)
115 BRADLEY COURT
LAUREL SPRINGS, NJ 08021
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/19/2003 |
|
GILL, JEFFREY J. (DPM)
1168 BEACON AVENUE
MANAHAWKIN, NJ 08050
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/13/1999 |
Permanent |
GILL, YURI (CHHA)
13 PINE GLEN DRIVE
SICKLERVILLE, NJ 08081
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/19/2017 |
9/4/2024 |
GILLARD, MARY (RN)
321 SUNSET AVE., APT.2H
ASBURY PARK, NJ 07712
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/20/2003 |
|
GILLER, LEONID
4 WOODFERN STREET
EDISON, NJ 08820
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/27/1999 |
Permanent |
GILLIARD, MICHELLE (CHHA)
2929 HURLEY POND ROAD
WALL, NJ 07719
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/20/2017 |
|
GILLISS, ADAM (DO)
27 EAST CHESTNUT AVENUE
MERCHANTVILLE, NJ 08109
NPI-1982741328 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/16/2015 |
|
GILMAN, DANIEL
FCI - FAIRTON, PO BOX 420
FAIRTON, NJ 08320
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2017 |
|
GILMAN, DENISE (DO)
108 WOODCREST DRIVE
CORAOPOLIS, PA 15108
NPI-1689986960 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
9/19/2016 |
GILMORE, BRUCE STEWART (MD)
FRANKLIN DRIVE
ARDMORE, OK 73401
NPI-1306985882 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/18/2008 |
|
JEROME DRUGS
7320 VENTOR AVENUE
VENTOR, NJ 08406GILTMAN, JEROME (RPH)
7320 VENTOR AVENUE
VENTOR, NJ 08406
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/30/2007 |
Permanent |
GIRARDY, MATTHEW (DDS)
1285 BRADFORD RUN
SPRING LAKE, NJ 07762
NPI-1831278118 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2019 |
|
GITKIN, SAMUEL
1288 15TH STREET
FORT LEE, NJ 07024
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/18/2002 |
|
GLASER, VICTORIA M. (RN)
1612 THIRD STREET
RENSSELAER, NY 12144
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/18/2002 |
|
GLASS, JOEL (MD)
2027 SPRING GARDEN STREET
PHILADEPHIA, PA 19130
NPI-1861537219 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/28/2017 |
Permanent |
GLASS, JOEL (MD)
2027 SPRING GARDEN STREET
PHILADEPHIA, PA 19130
NPI-1861537219 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/27/2017 |
Permanent |
GLASS, MICHAEL (MD)
1345 SLATERVILLE ROAD
ITHACA, NY 14850
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/18/2007 |
|
GODBOLT, KIMISHA (CHHA)
190 HAMILTON AVENUE
PATERSON, NJ 07501
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/24/2017 |
|
GODWIN, LASTAISA (PHARM TECH)
6 HILLSIDE TERRACE
SUSSEX, NJ 07461
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/1/2018 |
|
GOEPFERT, SARAH (LPN)
21 HOPKINS DRIVE
LAWRENCEVILLE, NJ 08648
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/8/2022 |
|
GOLDBERG, CHARLES S. (MD)
FCI-OTISVILLE, PO BOX 1000
OTISVILLE, NY 10963
NPI-1164443958 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/22/2016 |
|
GOLDBERG, RICHARD (MD)
FEDERAL BUREAU PRISONS-RRM #66231-050, 100 29TH STREET
BROOKLYN, NY 11232
NPI-1629136320 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/9/2017 |
|
GOLDBERG, RICHARD (MD)
95 DAVIS HILL ROAD
WESTON, CT 06883
NPI-1629136320 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/1/2015 |
|
GOLDIS, MICHAEL (MD)
36 STOKES ROAD
MOUNT LAUREL, NJ 08054
NPI-1982603247 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/30/2020 |
|
GOLDIS, MICHAEL EDWARD
36 STOKES ROAD
MOUNT LAUREL, NJ 08054
NPI-1982603247 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2024 |
|
GOLDSBORO, SIMONE (CNA)
932 MECHANIC STREET
CAMDEN, NJ 08104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/27/2024 |
|
GOLDSTEIN, JACK (DO)
695A MAIN STREET
LUMBERTON, NJ 08048
NPI-1154355055 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/28/2014 |
DECEASED |
GOLDSTEIN, JACK (DO)
695A MAIN STREET
LUMBERTON, NJ 08048
NPI-1154355055 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
DECEASED |
GOLDSTEIN, JEFFREY (DO)
90 BARNARD ROAD
NEW ROCHELLE, NY 10801
NPI-1831158088 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/14/2021 |
Permanent |
GOLDTHWAITE, JENNIFER (LPN)
507 KENBURY ROAD
BRANCHBURG, NJ 08876
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/15/2018 |
|
GOLEJ, IVY (RN)
631 MARION ROAD
NEPTUNE, NJ 07753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/9/2016 |
|
GOLEMBIOSKI, RICHARD C. (DMD)
5 ROUTE 94 VIKING VILLAGE, SUITE H
VERNON, NJ 07462
NPI-1831107150 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/15/2023 |
|
GOLIN, MARK W. (MD)
172 FRANKLIN AVE., SUITE4
RIDGEWOOD, NJ 07450
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/20/2003 |
|
GOMEZ, ALFREDO (CHHA)
148 NORTH 10TH STREET, 2ND FLOOR
PATERSON, NJ 07522
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/26/2018 |
|
GOMOLINSKI, NANCY ( LCSW)
23 FORSHEE CIRCLE
MONTVALE, NJ 07645
NPI-1700986890 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/7/2014 |
|
GONCALVES, COURTNEY J. (RN)
312 TEABERRY COURT
TOMS RIVER, NJ 08753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/25/2023 |
|
GONSHERY, DENISE C. (RPH)
900 MCELWEE ROAD
MOORESTOWN, NJ 08057
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/20/2005 |
|
GONZALEZ, ARELIS (CHHA)
28 MADOLE PLACE
PENNS GROVE, NJ 08069
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
GONZALEZ, FELICIA E.
FPC ALDERSON GLEN RAY ROAD, BOX A
ALDERSON, WV 24910
NPI-1598850935 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2024 |
|
GONZALEZ, FELICIA E. (DO)
1203 GREEN VIEW WAY
TOMS RIVER, NJ 08753
NPI-1598850935 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
9/19/2011 |
6/17/2013 |
GONZALEZ, FELICIA E. (DO)
1205 GREENVIEW WAY
TOMS RIVER, NJ 08753
NPI-1598850935 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/30/2024 |
Permanent |
GONZALEZ, JORDAN (RPH)
FCI FAIRTON #66214-050, PO BOX 420
FAIRTON, NJ 08320
NPI-1992073167 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/9/2017 |
|
GONZALEZ, KALER E. (RN)
113 WALNUT STREET
NEPTUNE, NJ 07753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/31/2023 |
|
GONZALEZ, LEAH (CHHA)
5 TWIN RIVERS DRIVE
EAST WINDSOR, NJ 08520
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/16/2017 |
5/6/2021 |
GONZALEZ, MIGUEL A. (MD)
P.O. BOX 208
HELLERTOWN, PA 18055
NPI-1275543340 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/10/2022 |
|
GONZOPH, BARBARA AKA DUFFY, BARBARA (LPN)
208 WAYNE TERRACE
COLLINGSWOOD, NJ 08108
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/19/2004 |
|
GOOBERMAN, LANCE (MD)
1 SOUTH CENTRE STREET
MERCHANTVILLE, NJ 08109
NPI-1194998682 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/24/2004 |
7/23/2012 |
GOODEY, KATHLEEN
333 WHITTIER AVENUE
DUNELLEN, NJ 08812
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
5/23/1997 |
|
GOODIN, RICHARD C. (MD)
RIVERVIEW CORRECTIONAL
OGDENSBURG, NY 13669
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
8/19/2004 |
|
GOODNIGHT, JAMES W. (MD)
535 HIGH MOUNTAIN ROAD
NORTH HALEDON, NJ 07508
NPI-1144313131 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/17/2014 |
4/11/2017 |
GOODWIN, BARBARA G. (RN)
1201 NORTH CHARLOTTE ST.
DICKSON, TN 37055
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/19/2002 |
|
GORCEY, STEVEN (MD)
32 VALLEY FORGE ROAD
EATONTOWN, NJ 07724
NPI-1679512941 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/11/2019 |
1/7/2021 |
GORDON, BARBARA (X -RAY TECH)
133 MORTON AVENUE
S. PLAINFIELD, NJ 07080
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/5/2001 |
Permanent |
GORDON, CRAIG W. (MD)
164 RIVEREDGE DRIVE #164
CHATHAM, NJ 07928
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/4/2007 |
|
GORDON, CRAIG W. (MD)
8 SHERWOOD CIRCLE
LINDEN, NJ 07036
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/18/1993 |
Permanent |
GORDON, HOWARD L. (MD)
222 BROADWAY
NEWARK, NJ 07104
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
GORDON, RAHSHEEDA (CHHA)
445 SOUTH 11TH STREET
NEWARK, NJ 07103
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
GORIGANTI, MAHENDER (MD)
7187 WOODCHUCK HILL ROAD
FAYETTEVILLE, NY 13066
NPI-1144202805 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2015 |
|
GOROVITS, LILIA (MD)
1157 METTLER ROAD
HUNTINGTON VALLEY, PA 19006
NPI-1427163427 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/7/2017 |
|
GORUKANTI, SURENDER (MD)
4324 BEDFORD AVENUE
BROOKLYN, NY 11229
NPI-1750488292 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2018 |
|
GORUKANTI, SURENDER (MD)
4324 BEDFORD AVENUE
BROOKLYN, NY 11229
NPI-1750488292 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2019 |
Permanent |
GOTAY, ALEXANDER (LCSW)
SSCF, P.O. BOX 150
DELMONT, NJ 08314
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/24/2008 |
|
GOUDA, NEEMAT G. (CHHA)
78 FREMONT STREET
JERSEY CITY, NJ 07302
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/4/2023 |
|
GOULBOURNE, MARIANA (CHHA)
430 S. 13TH STREET
NEWARK, NJ 07103
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/6/2018 |
|
GOULD, CRYSTAL NEIGER a/k/a CRYSTAL BIANCHI (NP)
8125 DEVON STREET
PHILADELPHIA, PA 19118
NPI-1790999076 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/22/2025 |
|
GRANGER, MAI AKA GRIFFITHS, MAI (CHHA)
15 PEPPERMINT LANE
WILLINGBORO, NJ 08046
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/29/1999 |
10/15/2024 |
GRANT, NICOLE (CHHA)
18 BUCKNELL DRIVE
TOMS RIVER, NJ 08757
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
GRANVILLE, PEDRO JULIO (CLIN LAB TECH)
823 BROAWAY
WEST LONG BRANCH, NJ 07764
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2015 |
|
GRASSER, JENNIFER B. AKA KROWICKI, JENNIFER (RN)
232 CLUB DRIVE
WALL, NJ 07719
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2002 |
|
GRAUERHOLZ, JOHN E. (MD)
P.O. BOX 2172
LEESBURG, VA 22075
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2002 |
|
GRAY, KEVIN
129 CHANCELLOR AVE
NEWARK, NJ 07112
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
GRAY-KEARLY, ASHLEE (CHHA)
10 CORAL DRIVE
HOWELL, NJ 07731
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
GRAYOVSKI, ELIZABETH (CHHA)
206 NORTHFIELD ROAD
MILLINGTON, NJ 07946
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/14/2017 |
|
THIRO AND GRAYSON INC
449 AVENUE C
BAYONNE, NJ 07002GRAYSON, MURRAY A. (RPH)
163 HAMPTON GREEN
STATEN ISLAND, NY 10312
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
GRAZIADEI, PAMELA J. (RN)
175 N MAIN STREET
YARDLEY, PA 19067
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2023 |
|
GRAZIANO, NATALE (MD)
470 BROOKSIDE LANE
SOMERVILLE, NJ 08876
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
GREEN, JOHN N. (MD)
3 PADDOCK COURT
BASKING RIDGE, NJ 07920
NPI-1114072444 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
9/25/2014 |
|
GREEN, JOHN N. (MD)
61 MAIN STREET
WEST ORANGE, NJ 07102
NPI-1114072444 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
2/22/2012 |
6/21/2012 |
GREEN, JOYCE D. (CHHA)
PO BOX 145
WOODBINE, NJ 08270
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2003 |
|
GREEN, ROBERT (MD)
22 OLD SHORT HILLS ROAD
LIVINGSTON, NJ 07039
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/2/1992 |
DECEASED |
GREEN, SHANNON R. (LPN)
19 MADELEY COURT
SICKLERVILLE, NJ 08081
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/3/2022 |
|
GREENBERG, ANTHONY (MD)
576 STATE ROUTE 94
COLUMBIA, NJ 07832
NPI-1487641239 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/29/2016 |
|
ORANGE DRUG & SURGICAL IN
270 HIGHLAND ROAD
S. ORANGE, NJ 07079GREENBERG, EDMUND (RPH)
270 HIGHLAND ROAD
S. ORANGE, NJ 07079
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/7/2000 |
DECEASED |
GREENBERG, LAUREN (LPN)
2376 WEST MAIN STREET
MILLVILLE, NJ 08332
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/25/2019 |
|
GREENFARB, IRVING (DO)
160 LITTLETON ROAD
MORRIS PLAINS, NJ 07950
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/19/1988 |
DECEASED |
GREENFIELD, RONALD W.
227 CLUB DRIVE
WALL, NJ 07719
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/19/2001 |
|
GREENLEAF, JANICE (LPN)
110 EAST JUNIPER AVENUE
NORTH WOLDWOOD, NJ 08260
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2005 |
|
GREENSPAN, BERNARD (DO)
484 LAFAYETTE AVENUE
HAWTHORNE, NJ 07506
NPI-1245231406 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/4/2017 |
Permanent |
GREENSPAN, BERNARD (DO)
150 OVERLOOK AVENUE, 10C
HACKENSACK, NJ 07601
NPI-1245231406 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/29/2017 |
Permanent |
GREER, CALEB (APN)
1703 BRADFORD CT.
CORINTH, TX 76210
NPI-1629630702 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/15/2025 |
|
GRETZULA, CHAD (DMD)
616 EAST LANCASTER AVENUE
BERWYN, PA 19312
NPI-1558422311 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
GREUNER, DAVID (MD)
14 E 60TH STREET, STE 501
NEW YORK, NY 10022
NPI-1063627347 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/14/2022 |
|
GRIETZER, JOY (RN)
406 EAST FRANKLIN AVENUE
WEST BERLIN, NJ 08091
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/22/2017 |
|
GRIFFIN, CHARLES (RPH)
HAZELTON USP, PO BOX 2000
BRUCETON, WV 26525
NPI-1669757530 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
GRIFFIN, REMY (CHHA)
490 PARK AVENUE, APT. #3-B
PATERSON, NJ 07504
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2017 |
|
GRIFFIN-MILLER, CHERYL a.k.a. MILLER, CHERYL A. (RN)
505 HILLSDIE AVENUE #1
ORANGE, NJ 07050
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/18/2024 |
|
GRIFFITHS, MAI AKA GRANGER, MAI (CHHA)
15 PEPPERMINT LANE
WILLINGBORO, NJ 08046
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/29/1999 |
10/15/2024 |
GRIMES, BRIDGET
293 LINCOLN STREET
PHILLIPSBURGH, NJ 08865
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
10/29/2012 |
|
GRINBERG, SAGY (MD)
201 LYONS AVENUE
NEWARK, NJ 07112
NPI-1093177503 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
6/1/2023 |
|
GRINBERG, SAGY (MD)
900 AVE AT PORT IMPERIAL BLVD APT 1018
WEEHAWKEN, NJ 07086
NPI-1093177503 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2023 |
|
GRINSHPUN, LEV (CHHA)
201-F MORRIS AVENUE
ELIZABETH, NJ 07208
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/22/2017 |
|
GRISSON, SANDRA
30 SOUTH CHURCH STREET, APT. 5
WAYNESBORO, PA 17268
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2015 |
|
GROSS, KENNETH (DC)
333 PROVINCIAL DRIVE
MORGANVILLE, NJ 07751
NPI-1740488709 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/20/2018 |
|
GROSSETT II, KENNETH W. (RPH)
SOUTH DUPONT ROAD
CARNEYSPOINT, NJ 08069
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/20/2008 |
|
GRULLON, KADIA (CHHA)
204 ACKERMAN AVENUE
CLIFTON, NJ 07011
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/19/2018 |
|
GUALTIERI, CHRISTOPHER
109 KARENLYNN DRIVE
FRANKLINVILLE, NJ 08322
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/29/2023 |
|
GUALTIERI, CHRISTOPHER E.
FCI ELKTON, P.O. BOX 10
LISBON, OH 44432
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/19/2024 |
|
GUANMESIA, EUNICE AKA MANJO, EUNICE (RN)
128 FIELDBROOK DRIVE
MAGNOLIA, DE 19962
NPI-1811443815 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/3/2019 |
|
GUENSCH, LISA M. (RN)
85 MORNING GLORY ROAD
WARREN, NJ 07059
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2009 |
|
GUERRERO, RAUL
110 JEROME AVENUE
SOUTH BOUND BRO, NJ
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/20/2004 |
|
GUERRERO, THAMARA (CHHA)
327 OUTWATER LANE #2
GARFIELD, NJ 07026
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/6/2018 |
|
GUERRIERO, LU ANN M. (DC)
21 KILMER DR, STE 2A
MORGANVILLE, NJ 07751
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/24/1997 |
|
GUICE SR., JASON C.
725 ELIZABETH AVE.
NEWARK, NJ 07112
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/15/2004 |
|
GUICE, AZIE VICE PRESIDENT
725 ELIZABETH AVENUE
NEWARK, NJ 07112
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/5/2005 |
|
GUILBERT, RICARDO (LPN)
SOUTHERN STATE CORREC FAC
DELMONT, NJ 08314
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/21/1995 |
Permanent |
GUILIANO, GINA (RN)
1 KINDERKAMACK ROAD
WOODCLIFF LAKE, NJ 07677
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/18/2003 |
|
GUINTU, PHILLIPPE M. (LPN)
80 SUNSET STREET
DUMONT, NJ 07628
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/3/2022 |
|
GULLA, FRANK T. (MD)
113 RTE. 46 W. WILLOW SQ.
WAYNE, NJ 07470
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/7/1999 |
Permanent |
GUPTA, ADARSH (DO)
2521 WEST MAIN STREET
NORRISTOWN, PA 19403
NPI-1003896523 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/20/2026 |
|
GUPTA PHARMACY
1700 OAK TREE ROAD
EDISON, NJ 08820GUPTA, NAVEEN (RPH)
1700 OAK TREE ROAD
EDISON, NJ 08820
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/4/1999 |
Permanent |
GUPTA, RASHMI J. (COUNSELOR)
203 HASSE AVENUE
PARAMUS, NJ 07652
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
7/30/2012 |
|
GUPTA, RASHMI J. (COUNSELOR)
10913 CORY LAKE DRIVE
TAMPA, FL 33647
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
7/3/2013 |
|
GUPTA, ROHIT #000263228G
BAYSIDE STATE PRISON, PO BOX F-1
LEESBURG, NJ 08327
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/4/2019 |
|
GURBAN, ELHAN
14 FAHRNER STREET
BERGENFIELD, NJ 07621
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/16/2016 |
|
GURBAN, ELHAN
SOUTHERN STATE CORRECTIONAL, 4295 ROUTE 47
DELMONT, NJ 08314
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/16/2015 |
|
GUREVICH, NATALIA (MD)
31-23 CRESCENT ST. APT 2C
ASTORIA, NY 11106
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2005 |
|
GUSSMAN, MICHAEL (DPM)
141 GREENBROOK DRIVE
MARLTON, NJ 08053
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2001 |
|
GUTIERREZ, SALLY (CHHA)
1005 MADISON AVENUE, STE 2
PATERSON, NJ 07501
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/5/2023 |
|
GUYTON, KATHLEEN
228 SANFORD STREET
EAST ORANGE, NJ 07018
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2002 |
|
GUZZI, NICOLE (CHHA)
117 SHERIDAN AVENUE
ROSELLE PARK, NJ 07204
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/2/2018 |
|
GYAPONG, WILLIAM (CHHA)
5 LORETTO STREET
NEWARK, NJ 07112
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/29/2019 |
|
HABIB, IMAD
1529 39TH STREET 1ST FL
NORTH BERGEN, NJ 07047
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/30/2011 |
|
HAFTEK, EILEEN (RN)
302 BELLVALE LAKES ROAD
WARWICK, NY 10990
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/30/2024 |
|
HAHN, JENNIFER I. (APN/RN)
6125 N. GUAVA LANE
LAKE WORTH, FL 33462
NPI-1184645772 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2024 |
|
EAST BROADWAY MEDICAL ASSOCIATES
195 BROADWAY
PATERSON, NJ 07505HAIDER, MOHAMMED M.
195 BROADWAY
PATERSON, NJ 07505
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
12/7/1999 |
|
HAINES, KEITH (MD)
1210 BRACE ROAD
CHERRY HILL, NJ 08034
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/15/1991 |
DECEASED |
HAINES, RAMONA L. (RN)
103 MEADOWVIEW CIRCLE
MARLTON, NJ 08053
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/19/2004 |
6/16/2022 |
HAINES, ROBBIE A. (RN)
WHITE POND COURT
ABSECON, NJ 08205
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/18/2007 |
|
HAITMANEK, OTTILLIE M. (LPN)
4162 BAYBERRY COURT
MONMOUTH JUNCTION, NJ 08852
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/28/2017 |
|
HALAS, JOHN
144 WHITEHALL DRIVE
VOORHEES, NJ 08043
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2002 |
|
HALL, AFRIKA AKA JACKSON, AFRIKA
BRIARWOOD DRIVE
TOBYHANNA, PA 18466
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/2/2007 |
6/28/2018 |
HALL, ANNA M. (RN)
44 LAKE TRAIL EAST
WAYNE, NJ 07470
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/18/2001 |
|
HALL, KIM
5 UNAMI LANE
SCOTCH PLAINS, NJ 07076
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/23/2009 |
Permanent |
HUDSON MEDICAL LIVERY
100 RESERVOIR AVENUE
JERSEY CITY, NJ 07307HAMAD, ALHIBER K.
100 RESERVOIR AVENUE
JERSEY CITY, NJ 07307
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
HAMBERG, IVAN (OD)
49 W. CHELTEN AVENUE
PHILADEPHIA, PA 19144
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/27/2001 |
Permanent |
HAMDAN, AIMAN (MD)
7 OAK HILL DRIVE
WAYNE, NJ 07470
NPI-1336186600 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2018 |
|
HAMDAN, KRISTINA
7 OAK HILL DRIVE
WAYNE, NJ 07470
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/16/2017 |
|
HAMDAN, KRISTINA #70919-050
ALDERSON FPC, GLEN RAY ROAD, BOX A
ALDERSON, WV 21910
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/4/2019 |
|
ANDAS PHARMACEUTICAL SUPPLY CORP.
592 PALISADE AVENUE
TEANECK, NJ 07666HAMED, AHMED
592 PALISADE AVENUE
TEANECK, NJ 07666
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2018 |
|
HAMEEDI, FAWAD (MD)
79 WASHINGTON AVENUE
NORTH HAVEN, CT 06473
NPI-1124318068 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/2022 |
|
HAMENOO, LOVESDALE AKA ADADEVOH, LOVESDALE (CHHA)
1 SKYTOP GARDENS, APT. 19
PARLIN, NJ 08859
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/16/2019 |
|
HAMM, CARRIE (RN)
1134 N. STILES STREET
LINDEN, NJ 07036
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/23/2010 |
2/23/2013 |
HAMM, CARRIE (RN)
1134 N STILES STREET
LINDEN, NJ 07036
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2003 |
2/23/2013 |
HAMPTON, GLYNDA
571 MONTGOMERY STREET
JERSEY CITY, NJ 07302
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/29/2002 |
Permanent |
HAN, DANIEL
481 WALKER STREET, APT. 1D
FAIRVIEW, NJ 07022
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/29/2016 |
|
HANDERHAN, LEROY (RN)
909 ABINGTON ROAD
CHERRY HILL, NJ 08034
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2007 |
|
HANDS, EVELYN (CHHA)
789 WHEATLAND COURT
CAMDEN, NJ 08104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/27/2006 |
|
HANLEY, KEVIN
10203 SPRINGRIDGE AVENUE
BATON ROUGE, LA 70810
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2023 |
|
HANNA, ALEXANDRA (LPN)
51 NORTHRUP DRIVE
BRICK, NJ 08724
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2018 |
|
HANNA, ASHRAF (PHARM TECH)
50 WILLETT AVENUE
SOUTH RIVER, NJ 08882
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/21/2016 |
|
HANNAN, SR., PAUL (MD)
6619 WALLASTON COURT
BROOKLYN, NY 11204
NPI-1639166572 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/15/2021 |
|
HANSCOM, CRYSTAL (RPH)
1407 BROMLEY ESTATES
PINE HILL, NJ 08021
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/8/2011 |
9/6/2016 |
HANSON, JUSTIN
F.C.I. THOMSON P.O. BOX 1002
THOMSON, IL 61285
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/18/2025 |
|
HARPER, JENNIFER R. (RN)
131 HEMLOCK COURT
WOODBURY, NJ 08096
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/19/2003 |
|
HARRELL, PAMELA L. (RN)
1150 REDROCK CANYON RD
KATY, TX 77450
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2002 |
|
HARRIGAN, DAVID C. (DC)
161 W. WHITE HORSE PIKE
ABSECON, NJ 08201
NPI-1932155736 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/1995 |
|
HARRIS, AMBER
19 RUFFED GROUSE PATH
LAKE ARIEL, PA 18436
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/5/2024 |
|
HARRIS, JOHNNIE
2 LAKE BLVD
EWING, NJ 08638
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/22/2006 |
Permanent |
HARRIS, PAUL AKA PATEL, HARISH (MD)
GB-46 PO BOX 26010
BEAUMONT, TX 77720
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/20/2006 |
|
HARRISON, RONISHA (CHHA)
96 KNIGHTS BRIDGE WAY
MAYS LANDING, NJ 08330
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/9/2018 |
|
HARRIS-POOLE, IRENE (PTA)
708G LUCAS LANE
VOORHEES, NJ 08043
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/20/2003 |
|
HARVEY, GREGORY (MD)
3535 MANOR ROAD
BETHLEHEM, PA 18020
NPI-1710926480 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/20/2025 |
Permanent |
HARVILIK, DOROTHEA (RN)
20 EAST ALLENDALE ROAD
SADDLE RIVER, NJ 07458
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/28/2017 |
Permanent |
HASSAN, FAWZIA (CHHA)
3413 JOHN F. KENNEDY BLVD., APT. 3
JERSEY CITY, NJ 07307
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/28/2023 |
|
HASSAN, MONA (CHHA)
94 W 22ND STREET, APT. 1
BAYONNE, NJ 07002
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/28/2024 |
|
HASSAN, SALAH A.
105 TONNELLE AVENUE
JERSEY CITY, NJ 07305
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/31/2001 |
Permanent |
HASSETT, IRENE (PHD)
950 MORGAN HIGHWAY 226
SOUTH ABINGTON, PA 18411
NPI-1801894803 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
HATCHER-MURPHY, KIMBERLY AKA HURBAN, KIMBERLY (LPN)
966 HERMAN DRIVE
DEPTFORD, NJ 08051
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/18/2018 |
|
HATTON, JOSEPH R. (RN)
41 DOGWOOD DRIVE
SOMERS POINT, NJ 08244
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/14/2023 |
|
HECHT, GARY S. (DC)
42 SPRINGBROOK ROAD
LIVINGSTON, NJ 07093
NPI-1417145194 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/14/2024 |
|
HEGGS, PAMELA B.
P.O. BOX 4004
CLINTON, NJ 08809
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/18/2007 |
|
HEINRICH, SARATU (CHHA)
435 STUYVESANT AVENUE, FLOOR 1
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2023 |
|
HELLER, ELLIOT M. (MD)
1150 AMBOY AVENUE
EDISON, NJ 08837
NPI-1770688723 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/29/2003 |
6/25/2014 |
HENRY, ANN-MARIE (CHHA)
253 E. 33RD STREET, APT 1
PATERSON, NJ 07504
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/27/2025 |
|
HENRY, SARA (RN)
54 CARVER AVENUE
LINDENWOLD, NJ 08021
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/7/2008 |
|
HERMAN, LAWRENCE S. (DC)
8908 DANVILLE TERRACE
FREDERICK, MD 21701
NPI-1881664761 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2015 |
|
HERMAN, THERESA (RN)
676 HARBOR ROAD
BRICK, NJ 08724
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2004 |
|
HERNANDEZ, FRANCHESCA (CHHA)
256 N 11TH STREET
NEWARK, NJ 07107
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/4/2023 |
|
HERNANDEZ, JENNIFER OFELIA (CHHA)
1410 OAK TREE DRIVE (H)
NORTH BRUNSWICK, NJ 08902
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/25/2013 |
|
HERNANDEZ, NORA LEE (LPN)
4820 OLD HARRISBURG ROAD, LOT 27
GETTYSBURG, PA 17325
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
HERNANDO, GILDA
669A CHAMBERS STREET
TRENTON, NJ 08611
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/8/2002 |
|
HERSCHMAN, ZVI J. (MD)
1 OLD SHORT HILLS ROAD
LIVINGSTON, NJ 07039
NPI-1033217492 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/28/2013 |
|
HERSCHMAN, ZVI J. (MD)
346 WILSON STREET
WEST HEMPSTEAD, NY 11552
NPI-1033217492 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/20/2013 |
|
HERSHAN, DAVID (MD)
33 OWATONNA STREET
HAWORTH, NJ 07641
NPI-1740280957 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/18/2017 |
|
HESSEIN, AMGAD A. (MD)
483 SOUTH ORANGE AVENUE
SOUTH ORANGE, NJ 07079
NPI-1578637260 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
1/26/2012 |
5/25/2016 |
HESSEIN, AMGAD A. (MD)
24 DOGWOOD COURT
WOODLAND PARK, NJ 07424
NPI-1578637260 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/25/2016 |
|
HESSEIN, AMGAD A. (MD)
BAYSIDE STATE PRISON, PO BOX F-1
LEESBURG, NJ 08327
NPI-1578637260 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/1/2017 |
|
HEUMAN, LISA M. a.k.a. BUCHMANN, LISA M. (LPN)
6618 REEGA AVENUE
EGG HARBOR TOWNSHIP, NJ 08234
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/19/2024 |
|
HEYMACH, GEORGE (MD)
801 W. 57TH TERRACE
KANSAS CITY, MO 64113
NPI-1568588317 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/27/2001 |
Permanent |
HEYMAN, JACK (DO)
124 E MT PLEASANT AVENUE
LIVINGSTON, NJ 07039
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/7/1983 |
DECEASED |
HIBBS, ELIZABETH AND ELIZABETH O'BRIEN
2201 BENJAMIN FRANKLIN PARKWAY, APT. 807
PHILADEPHIA, PA 19130
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/18/2019 |
|
HICKS, MYASIA (CHHA)
38-40 JOHNSON AVENUE
NEWARK, NJ 07108
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/8/2017 |
|
HIGGINS, GARY W. (RN)
548 WAYSIDE ROAD
NEPTUNE, NJ 07753
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2002 |
|
HIGGINS, MARTIN
706 BLOOMFIELD AVENUE
NUTLEY, NJ 07110
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/20/2005 |
|
HIGGINS, RANDALL T. (RPH)
17 WAVERLY PLACE
MATAWAN, NJ 07747
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/3/2017 |
|
HILLEY, KATHLEEN M.
219 CENTER STREET
TUCKERTON, NJ 08087
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/15/2010 |
|
HILTON JR., JAMES R. (DO)
28 BROCKTON COURT
BEACON FALLS, CT 06403
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/3/2002 |
|
HIMMELWRIGHT, VICTOR
44 LONDONBERRY WAY
SUMMIT, NJ 07901
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
HINSON, ANTHONY (RN)
566 RECTOR STREET
PHILADEPHIA, PA 19128
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/21/2020 |
|
HINSON, ANTHONY M. (RN)
566 RECTOR STREET
PHILADELPHIA, PA 19128
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/30/2023 |
Permanent |
HIRES, STEPHANIE (RN)
725 FORD AVENUE
LANGHORNE, PA 19047
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2018 |
|
HIRSCH, SCOTT
871 CORONADO CENTER DR., SUITE 200
HENDERSON, NJ 89052
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/2022 |
|
HIRSH, HOWARD (RPH)
163 EINSTEIN WAY
EAST WINDSOR, NJ 08512
NPI-1811204605 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/25/2016 |
|
HO, SHING (MD)
6 JAMOR COURT
NESCONSET, NY 11767
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/19/2000 |
|
HOANG, NGOC aka ANNIE HOANG (RN)
12046 COURSEY BLVD
BATON ROUGE, LA 70816
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/22/2022 |
|
HOCHBERG, JOHN (MD)
288 PLEASANT VALLEY ROAD
MORGANVILLE, NJ 07751
NPI-1134280480 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/14/2016 |
9/23/2022 |
HOCHBERG, JOHN (MD)
288 PLEASANT VALLEY ROAD
MORGANVILLE, NJ 07751
NPI-1134280480 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/17/2017 |
9/23/2022 |
HODGKISS, KATHLEEN (PSYCH)
151 KNOLLCROFT ROAD
LYONS, NJ 07939
NPI-1013179233 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/22/2017 |
|
HOFFMAN, KATHLEEN AKA SULIMENKO-HOFFMAN, KATHLEEN (LPN)
99 CREEK ROAD
BRICK, NJ 08724
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/13/2018 |
|
HOFFMAN, LISA M.
405 OLCOTT STREET
ORANGE, NJ 07050
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/31/2022 |
|
HOFFMAN, LISA M.
FCI DANBURY ROUTE 37
DANBURY, CT 06811
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2023 |
|
HOFFMAN, MARTIN L. (MD)
7 CAREFREE LANE
SUFFERN, NY 10901
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/29/2002 |
|
HOFFSPIEGEL, PAUL
56 SULLLIVAN DRIVE
WEST ORANGE, NJ 07052
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
8/6/1998 |
|
HOFSTETTER, DAVID OWNER
114 COUNTY ROAD 513
PITTSTOWN, NJ 08867
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/14/2000 |
|
HOLBROOK, DAVID V. (MD)
53 MAIN STREET
BLOOMSBURY, NJ 08804
NPI-1609943885 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/7/2025 |
|
HOLCA, LIVIU (MD)
1137 BEACON AVENUE
MANAHAWKIN, NJ 08050
NPI-1053348417 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/25/2014 |
|
HOLLENBAUGH, JUSTIN E. (RN)
616 LESTERSSHIRE DRIVE
SEWELL, NJ 08080
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2024 |
|
HOLLEY, AKEYA (CHHA)
11 MONTICELLO AVENUE, 2ND FLOOR
NEWARK, NJ 07106
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/13/2018 |
|
HOLLOWAY, JAZMINE (CHHA)
95 CUMMINGS AVENUE
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/23/2018 |
|
HOLLOWAY, LAKEZIA (CHHA)
1306 SUMMERFIELD AVENUE
ASBURY PARK, NJ 07712
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/13/2018 |
|
PARTNERS FOR HOPE
447 EAST 42ND STREET
PATERSON , NJ 07504HOLLOWAY, QUINCEY (LSW)
447 EAST 42ND STREET
PATERSON, NJ 07504
NPI-1689883001 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/17/2019 |
4/24/2019 |
HOLMES, THERESA (CHHA)
1290 N. 27TH STREET
CAMDEN, NJ 08105
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/12/2018 |
|
HOMAN, WALTER W. (CHHA)
FORECASTLE AVENUE
BEACHWOOD, NJ 08722
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/21/2008 |
|
HONG, JOSEPH S. (MD)
34 FOREST DRIVE
WATCHUNG, NJ 07069
NPI-1346258001 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/29/2016 |
|
HOOKE, KNYCKHOLLE
1050 HARRISON AVENUE
ROSELLE, NJ 07203
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
12/14/2022 |
|
HOPKINS, TANYA (CHHA)
433 EAST 18TH STREET, 2ND FLOOR
PATERSON, NJ 07524
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2019 |
|
HOPPE, GERALD
BOX 483A RD 1
MONROEVILLE, NJ 08343
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
HORN, MURRAY
287 GARFIELD AVE
HAWORTH, NJ 07641
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/19/1984 |
Permanent |
HORVATH, CHARLYN (RN)
3072 BORDENTOWN AVENUE
PARLIN, NJ 08859
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/27/2018 |
|
HORWITZ, KENNETH (RPH)
8 MOHAWK PLACE
RANDOLPH, NJ 07869
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/31/2003 |
7/20/2011 |
HOUJRA, LATIFA (CHHA)
82 KNICKERBOCKER AVE
PATERSON, NJ 07503
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/28/2024 |
|
HOUSTON, PLATINUM (CHHA)
15 COURTLAND LANE
WILLINGBORO, NJ 08046
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/19/2017 |
|
HOUTAN, FARAH (PTA)
269 STEELMANVILLE ROAD
EGG HARBOR, NJ 08234
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
5/1/2012 |
|
HOUTAN, FARAH (PTA)
269 STEELMANVILLE ROAD
EGG HARBOR TOWN, NJ 08234
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
10/27/2009 |
|
HOWARD, REGINA R.
104 E. 8TH STREET
LAKEWOOD, NJ 08701
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/30/2013 |
|
HOWARD, ROBIN A. (RN)
196 KING AVENUE
TRENTON, NJ 08638
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2001 |
Permanent |
HOWELL, BRIAN (LPN)
106 PARKER AVENUE #2
FORKED RIVER, NJ 08731
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/27/2017 |
|
HOWELL, CHRISTOPHER (CHHA)
978 JOLSON COURT
MANCHESTER TOWNSHIP, NJ 08759
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/26/2017 |
|
HOWELL, CLIFTON (MD)
15 COLONY DRIVE WEST
WEST ORANGE, NJ 07052
NPI-1942247622 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/19/2011 |
|
HOWELL, CLIFTON (MD)
15 COLONY DRIVE WEST
WEST ORANGE, NJ 07052
NPI-1942247622 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
10/18/2012 |
|
HRABARCHUK, EUGENE (MD)
925 CLIFTON AVENUE
CLIFTON, NJ 07013
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
HSIA, VINCENT (RPH)
SCHUYLKILL FCI
MINERSVILLE, PA 17954
NPI-1710209291 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/1/2014 |
|
HU, HSUN TUAN
154 HOMESTEAD PLACE
BOGOTA, NJ 07603
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/10/1999 |
Permanent |
HUBBARD, PETER (RN)
1051 WASHINGTON STREET, APT. 4
EASTON, PA 18042
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/25/2016 |
7/12/2022 |
HUDSON, FITZGERALD (MD)
PO BOX 1000
MILAN, MI 48160
NPI-1639367725 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
6/12/2014 |
|
HUERTA JR., FRANK
25 CHAPEL STREET
BROOKLYN, NY 11201
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/10/1997 |
|
HUNDA, RAFAEL (MD)
472 RIVER STREET
PATERSON, NJ 07524
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/21/2001 |
Permanent |
HUNTER, CHRISTOPHER (LPN)
430 BARTINE STREET
SOMERVILLE, NJ 08876
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2002 |
|
HUNTER, FRANK L.
6 HARTZ DRIVE
BRIDGETON, NJ 08302
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/20/2005 |
|
HURBAN, KIMBERLY AKA HATCHER-MURPHY, KIMBERLY (LPN)
966 HERMAN DRIVE
DEPTFORD, NJ 08051
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/18/2018 |
|
HURLEY, DOUGLAS #65501-050
FCI FAIRTON #66214-050, PO BOX 420
FAIRTON, NJ 08320
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/18/2019 |
|
HUSSAIN, IFTIKHAR
9 VAN COURTLAND AVENUE
STATEN ISLAND, NY 10301
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/29/2003 |
Permanent |
HUSSAIN, ZAHID (MD)
301 ROUTE 9 NORTH
FREEHOLD, NJ 07728
NPI-1992733232 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/30/2011 |
7/22/2016 |
HUSSKE, JULIE (RN)
1105 CRENDALL WAY
WAKE FOREST, NC 27587
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/10/2019 |
|
HUSTON JR., JOHN A. DN2591 (CHHA)
8 PRODUCTION WAY
AVENEL, NJ 07001
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/29/1997 |
|
HYMAN, DEBORAH
6 HASTINGS LANE
FLEMINTON, NJ 08822
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2006 |
|
HYMAN, RONALD M. (RPH)
3845 DEMPSEY
HUNTINGTON VALLEY, PA 19006
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/19/2005 |
|
IBRAHIM, ELFAITH MOHAMED
171 E. 5TH STREET, 1ST FLOOR
BROOKLYN, NY 11218
NPI-1881917318 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2024 |
|
IBRAHIM, ELHADI
125 HALF MILE RD, BOX 190
MIDDLETOWN, NJ 07748
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/29/2001 |
Permanent |
ATA MEDICAL TRANSPORTATION
55 WASHINGTON STREET, SUITE 600
EAST ORANGE, NJ 07017IBRAHIM, GASIM
340 FAIRMOUNT
JERSEY CITY, NJ 07306
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/11/1996 |
Permanent |
IBRAHIM, MOHAMMAD (MD)
871 MCBRIDE AVENUE
WOODLAND PARK, NJ 07424
NPI-1265494645 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/22/2016 |
|
IGBERASE, OLUWAFEMI AKA IGBERASE, CHARLES AKA AKODA, CHARLES (RN)
14909 DOWNEY COURT, SUITE 200
BOWIE, MD 20721
NPI-1609033042 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2018 |
|
IGBINADUWA, NEWTON (RPH)
116-35 139TH STREET
JAMAICA, NY 11436
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/19/2005 |
|
IGDIBE, PAUL (APN/RN)
1790 FRONT STREET, APT 17
EAST MEADOW, NY 11554
NPI-1912263831 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/19/2024 |
|
IGHAMA-AMEGOR, IBIOLA (MD)
59 MAPLE AVENUE
VAUXHALL, NJ 07088
NPI-1639251804 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/16/2017 |
|
IGHAMA-AMEGOR, IBIOLA (MD)
204 KEER AVENUE
NEWARK, NJ 07112
NPI-1639251804 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/18/2019 |
|
IGNACCOLO, EMANUELE (MD)
688 WYCHOFF AVENUE
MAHWAH, NJ 07430
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
DECEASED |
IKEH, CHIDI ETHELBERT
PO BOX 26030
BEAUMONT, TX 77720
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/9/2008 |
|
ILARDI, JEFFREY M. (MD)
171 WOODPORT ROAD
SPARTA, NJ 07871
NPI-1639193618 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/29/2024 |
|
ILEM, PRISCILLA G. (MD)
782 ALPS ROAD
WAYNE, NJ 07470
NPI-1699860684 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/27/2013 |
|
ILLINGWORTH, DONNA (LPN)
1505 CLAIRE ROAD
FORKED RIVER, NJ 08731
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/19/2005 |
|
IMAN, INAS IKRAM (CHHA)
20 HADLEY LANE
WILLINGBORO, NJ 08046
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/28/2024 |
|
IMANE, HARRAFI (CHHA)
30 WASHINGTON PKWY, APT. B
BAYONNE, NJ 07002
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2023 |
|
INABOYA-SEPLA, QUEENETTE (CHHA)
243 MERCER STREET, APT 1
TRENTON, NJ 08611
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/17/2023 |
|
INGALLS, ANDREA (CHHA)
36 NORWOOD STREET, 3RD FLOOR
NEWARK, NJ 07106
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/19/2018 |
|
INNES JR., GEORGE MICHAEL (MD)
1736 EAST GENESEE STREET
FAYETTEVILLE, NY 13066
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/20/2005 |
|
INNOCENZI, ANTHONY (DPM)
7972 AQUADALE DRIVE
YOUNGSTOWN, OH 44512
NPI-1255336079 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2015 |
|
INSABELLA, HARRY (DDS)
591 SOMERSET ST.
SOMERSET, NJ 08873
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/1/1997 |
Permanent |
INTELISANO, RONALD (DO)
46 BUCKINGHAM DRIVE
BERLIN, NJ 08009
NPI-1235200775 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/3/2017 |
|
INTELISANO, RONALD (DO)
1504 BLACKWOOD CLEMENTON ROAD
BLACKWOOD, NJ 08012
NPI-1235200775 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2017 |
|
IOSIM, ANATOLY (CHHA)
9217 FALSTON CIRCLE
OLD BRIDGE, NJ 08857
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/20/2017 |
|
IQBAL, MOHAMMED S. (MD)
LINWOOD AVENUE
RIDGEWOOD, NJ 07450
NPI-1972564078 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
9/12/2008 |
|
IRBY, ARCHER (DC)
115 GRAND AVENUE
ENGLEWOOD, NJ 07631
NPI-1801927520 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/25/2016 |
|
IRVING, EDWARD J.
202 SEYMOUR AVENUE
NEWARK, NJ 07108
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/20/2004 |
|
ISAACSON, STEVEN (RPH)
1959 BIRCHWOOD PARK DRIVE
CHERRY HILL, NJ 08034
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/6/1995 |
Permanent |
ISHAK, ABRAM (CHHA)
132 EILEEN DRIVE
CEDAR GROVE, NJ 07009
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2023 |
|
ISKANDARANI, NIMER (MD)
38 PATTEN TERRACE
CEDAR GROVE, NJ 07009
NPI-1457498768 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/16/2021 |
Permanent |
ISMAIL, KHADEJAH (CHHA)
827 E. FRONT STREET, APT. C
PLAINFIELD, NJ 07062
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/5/2023 |
|
ISMAIL, MOHAMMAD (RPH)
4 GRAHAM COURT
PARSIPPANY, NJ 07054
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/18/2003 |
|
IVANOV, ALEXANDER (MD)
178 WATER STREET
PERTH AMBOY, NJ 08861
NPI-1790825222 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/15/2024 |
|
IVASHENKO, ALEXANDER (PT)
31 GOLDSMITH DRIVE
HOLMDEL, NJ 07333
NPI-1134289796 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/25/1999 |
|
IYENGAR, DEVARAJAN (MD)
27 EAST 29TH STREET
BAYONNE, NJ 07002
NPI-1689620700 |
Medical
Antitrust/Anti-Kickback Acts |
Suspension Human Services
Medical Assistance (Medicaid) |
8/25/2015 |
1/10/2017 |
JACKSON, AFRIKA AKA HALL, AFRIKA
BRIARWOOD DRIVE
TOBYHANNA, PA 18466
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/2/2007 |
6/28/2018 |
JACKSON, AMINATU (CHHA)
26 JAMES STREET, C12
LAKEWOOD , NJ 08701
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
JACKSON, AVILA TYRELL a.k.a. JACKSON, AVIA TYRELL
100 PHILLIPS ROAD, APT 62
SOMERSET, NJ 08873
NPI-1811196488 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/18/2020 |
|
JACKSON, DESHONETTE (CHHA)
419 EAST 27TH STREET, 2ND FLOOR
PATERSON, NJ 07515
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/19/2018 |
|
JACKSON, GEORGE D. (PSYCH)
367 FAIRVIEW AVE.
ORANGE, NJ 07050
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/30/1997 |
Permanent |
JACKSON, LATORRA (RN)
NEPTUNE, NJ 08859
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/20/2024 |
|
JACKSON, MAKEBA (CHHA)
15 MILL STREET
EATONTOWN, NJ 07724
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/14/2017 |
|
JACKSON, ZEKIA (CHHA)
232 JUSTIN WAY
WILLIAMSTOWN, NJ 08094
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/19/2017 |
2/26/2026 |
JACKSON-GILLARD, CRYSTALYNN (CHHA)
3 BORDEN AVENUE, APT. 8
ASBURY PARK, NJ 07712
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/24/2018 |
|
JACOBS, AMY (LPN)
620 MOUNTAIN ROAD
BUTLER, NJ 07405
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/5/2017 |
|
JACOBSON, CRAIG (DC)
1219 LIBERTY AVENUE
HILLSIDE, NJ 07205
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/24/2000 |
DECEASED |
JACOBSON, DEBRA
661 RT. 9
BAYVILLE, NJ 08721
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/25/2011 |
1/25/2013 |
JACOBSON, JAY P. (DC)
25 DEER PATH
HOLMDELL, NJ 07733
NPI-1508084385 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/12/1996 |
Permanent |
JACQUES, ARNOLD J. (MD)
31 BRIDGEWATER COURT
JACKSON, NJ 08527
NPI-1124170899 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/30/2011 |
|
JACQUEZ, MADELIN (CHHA)
2141 SOUTH CLINTON AVENUE
HAMILTON, NJ 08610
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/12/2018 |
|
JAFARI, MARYAM (MD)
80 LINDEN STREET APT. M
MILLBURN, NJ 07041
NPI-1831276880 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2014 |
7/9/2025 |
JAFARI, MARYAM (MD)
176 BLOOMFIELD AVENUE
NEWARK, NJ 07104
NPI-1831276880 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
2/22/2012 |
7/9/2025 |
JAFFERY, SYED (MD)
109 TROTTER ROAD
EGG HARBOR, NJ 08234
NPI-1235153685 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/15/2016 |
|
JAGTIANI, RAJA (MD)
10 ONTARIO STREET
DUMONT, NJ 07628
NPI-1659320281 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/6/2016 |
11/29/2016 |
JAGTIANI, RAJA (MD)
10 ONTARIO STREET
DUMONT, NJ 07628
NPI-1659320281 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
9/28/2015 |
|
JAHAN, TAHERA (CHHA)
4113 AVALON WAY
BLOOMINGDALE, NJ 07403
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/28/2024 |
|
JAIME, NESTOR E. (Pharm Tech)
293 CHESTNUT STREET, APT C10
NUTLEY, NJ 07110
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/17/2026 |
|
JAIN, SANJAY (MD)
4 CHAROLAIS FARM
MENDHAM, NJ 07945
NPI-1063455780 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/6/2025 |
Permanent |
JAKA, MICHAELLA a/k/a MICHAELLA CLINTON (CHHA)
9 KINGSTON LANE
SOUTH BRUNSWICK, NJ 08852
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/27/2025 |
|
JAKUBCZAK, ARTHUR F. (DC)
465 RATHBURN PLACE
PERTH AMBOY, NJ 08861
NPI-1053493718 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/18/2001 |
10/26/2001 |
JAMES, EDWARD (DO)
505 GROVE STREET
SEWICKLEY, PA 15143
NPI-1598789703 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
JAMES, GLORIA M. (RN)
18 LINDEN COURT
JERSEY CITY, NJ 07305
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/20/2005 |
|
JAMES, SULENNY (CHHA)
293-295 BROAD STREET, 2ND FLOOR
NEWARK, NJ 07104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/27/2017 |
|
JAMISON, ROBERT W. (DO)
79 PARTRIDGE LANE
CHERRY HIL, NJ 08003
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/11/2000 |
Permanent |
JANOF, ROY
502 WASHINGTON STREET
HOBOKEN, NJ 07030
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/9/1983 |
Permanent |
JANVIER-PIERRE, MARY
6400 BRIDGEPORT LANE
LAKE WORTH, FL 33463
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
5/20/2012 |
|
JARMON, ROBERT G. (MD)
8 BRIGHTON AVENUE
SPRING LAKE, NJ 07762
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/9/2002 |
|
JASCALEVICH, MARIO E. (MD)
10 PRISCILLA LANE
ENGLEWOOD CLIFF, NJ 07632
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
DECEASED |
JASINSKI, DARIUS (DPM)
1225 MCBRIDE AVENUE
WOODLAND PARK, NJ 08424
NPI-1013995182 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/29/2016 |
9/22/2020 |
JASPER, SARAH (CHHA)
187 SIERRA COURT
WOODBRIDGE, NJ 07095
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
JASPER, THEODORE (MD)
1010 CLIFTON AVENUE
CLIFTON, NJ 07013
NPI-1528171972 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/16/2015 |
|
JASPER, THEODORE (MD)
1010 CLIFTON AVENUE
CLIFTON, NJ 07013
NPI-1528171972 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/12/2015 |
|
JASZCZULT, JOAN E. (DO)
50 NEWARK AVENUE, APT 309
BELLEVILLE, NJ 07109
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/3/2006 |
|
JAVID, MOHAMMAD A.
E. JERSEY STATE PRISON
RAHWAY, NJ 07065
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2000 |
|
JAVID, MOHAMMAD A.
63 FEDERAL STREET
METUCHEN, NJ 08840
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/11/1996 |
Permanent |
JAYARAM, AJIT (MD)
215 SOUTH BURLINGTON ROAD
BRIDGETON, NJ 08302
NPI-1295773869 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2013 |
|
JAYARAM, AJIT (MD)
215 SOUTH BURLINGTON ROAD
BRIDGETON, NJ 08302
NPI-1295773869 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/4/4014 |
|
JEAN-BAPTISTE, DEMESVAR A. (MD)
775 MOUNTAIN BLVD STE 1
WATCHUNG, NJ 07069
NPI-1831227719 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2011 |
DECEASED |
JECK, CHARLES N. (DO)
1 CHICKORY PLACE
NEWTOWN, PA 18940
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
7/5/2002 |
|
JEDJU, LINDA (CHHA)
33 NINTH STREET, PO BOX 644
FLAGSTOWN, NJ 08824
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/27/2016 |
|
JEFFERSON, MICHAEL K. (DMD)
408 PADDOCK COURT
SEWELL, NJ 08080
NPI-1811956238 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/16/2016 |
5/12/2017 |
JEFFRIES, MARC
2 MILLER LANE
WHITEHOUSE STAT, NJ 08889
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/13/2014 |
|
JELKS, SAMARRA (CHHA)
3309 RIDGEWAY ROAD
MANCHESTER TOWNSHIP, NJ 08759
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/28/2017 |
|
JEMINI, DAVID
PO BOX 280, HWY. 698
FAIRTON, NJ 08320
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/18/2002 |
|
JEMINI, JACK
PO BOX 600
ELGIN, FL 32542
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/18/2002 |
|
JIMENEZ, CRISTIAN (RN)
61 CHESTNUT STREET, APT. 3C
ONEONTA, NY 13820
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/10/2019 |
|
JIMENEZ, JOSE (COUNSELOR)
EXTENSION VILLA RITA
SAN SEBASTIAN, PR 00685
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/8/2003 |
12/8/2011 |
JIMENEZ, MAGDALENA A. a/k/a MAGGIE JIMENEZ
22 VIOLA AVENUE
CLIFTON, NJ 07011
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/20/2024 |
|
JIMENEZ, ZOILA (CHHA)
458 PROSPECT STREET, APT. 3
LAKEWOOD, NJ 08701
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/5/2023 |
|
JIN, JINHUA
405 CELEBRATION AVENUE
KISSIMMEE, FL 34747
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/19/2022 |
|
JITAN, RAED (MD)
1 BETHANY ROAD
HAZLET, NJ 07730
NPI-1033167986 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/10/2021 |
|
JOACHIM, LEONARD (MD)
26 LAKE DRIVE
MOUNTAIN LAKES, NJ 07046
NPI-1720023005 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/5/1997 |
Permanent |
JOACHIM, LEONARD (MD)
25 HIDEAWAY LANE
SPARTA, NJ 07871
NPI-1720023005 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/5/2017 |
|
JOACHIM, STEPHANEM (CHHA)
15 LINDSLEY PLACE, APT. 1R
EAST ORANGE, NJ 07018
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
JODELKA, ERIK (RPH)
391 BEECROFT PLACE
OAKHURST, NJ 07755
NPI-1003103946 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/20/2006 |
2/23/2011 |
JOHAL, GURVINDRA S. (DO)
16 PARSON PLACE
COLONIA, NJ 07067
NPI-1871551721 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/8/2023 |
|
JOHAL, GURVINDRA S. (DO)
16 PARSON PLACE, APT 1
COLONIA, NJ 07067
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/20/2025 |
|
JOHNSON, ALICIA (LPN)
20 SKYTOP GARDENS
PARLIN, NJ 08859
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/12/2016 |
|
JOHNSON, BEVERLY (CHHA)
909 ARMSTRONG BOULEVARD, APT 3A
ASBURY PARK, NJ 07712
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/17/2018 |
|
JOHNSON, BRENDA C. (LPN)
232 OAK STREET
WILLIAMSTOWN, NJ 08094
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/19/2003 |
|
JOHNSON, CALLISHA (CHHA)
1250 PRINCESS AVENUE
CAMDEN, NJ 08103
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/5/2019 |
|
JOHNSON, DARLA (LPN)
4 STELTON ROAD UNIT C
PISCATAWAY, NJ 08854
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/25/2022 |
|
JOHNSON, DEMETRIA (CHHA)
21 ROSA PARK BOULEVARD
PATERSON, NJ 07524
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/31/2017 |
3/23/2026 |
JOHNSON, DENISE M. (RN)
12 SIOUX TRAIL
DENVILLE, NJ 07834
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/20/2005 |
|
JOHNSON, DUWANA L. (CHHA)
213 MARTIN LUTHER KING DR
LAKEWOOD, NJ 08701
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/14/2005 |
|
JOHNSON, JOANNA N. (LPN)
70 LAUREL DRIVE
MAPLE SHADE, NJ 08052
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/18/2022 |
|
JOHNSON, JOHN
33 GRAPEVINE ROAD
LEVITTOWN, PA 19057
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
12/14/2022 |
|
JOHNSON, JULIE ANN (CHHA)
1145 MANTUA PIKE
MANTUA, NJ 08051
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/19/2001 |
|
JOHNSON, KIM E. (LPN)
68 JANS WAY
BYRAM TOWNSHIP, NJ 07821
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/16/2017 |
|
JOHNSON, LARHONDA (CHHA)
1704 CENTENNIAL VILLAGE
CAMDEN, NJ 08105
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
JOHNSON, MICHAEL (LPN/RN)
899 DIANE COURT
WOODBRIDGE, NJ 07095
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/28/2017 |
|
JOHNSON, ROBERT
1608 4TH AVE.
ASBURY PARK, NJ 07712
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/6/2006 |
|
JOHNSON, SHYKIRA (CHHA)
152 BELMONT AVENUE, APT. 2
PATERSON, NJ 08522
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/28/2018 |
|
JOHNSTON, JOHN JOSEPH (CHIROPRACTOR)
3311 NW 18TH AVENUE, APT 18
GAINESVILLE, FL 32605
NPI-1871691071 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/18/2024 |
|
JOHNSTON, KELLIE (RN)
1697 SYLVAN DRIVE
BLUE BELL, PA 19422
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/19/2006 |
|
JOHNSTON, MICHAEL #MX4261 (MFT)
SCI CAMP HILL, PO BOX 200
CAMP HILL, PA 17001
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/29/2017 |
|
JONES, AARAON DASHAWN (MEDICAL ASSISTANT)
30 TIPTON LANE
WILLINGBORO, NJ 08046
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/20/2022 |
|
JONES, ANIECE (LPN)
625 DREXEL AVENUE
ATLANTIC CITY, NJ 08401
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/4/2018 |
|
JONES, CYNTHIA R. (RN)
1089 HAWSER AVENUE
MANAHAWKIN, NJ 08050
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2002 |
|
JONES, DAVID (LPN)
97 LINCOLN PARK
NEWARK, NJ 07102
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/20/2003 |
|
JONES, IMAJE (CHHA)
287 ABLETT VILLAGE
CAMDEN, NJ 08105
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
JONES, JASMINE (CHHA)
304 ERIAL ROAD
SICKLERVILLE, NJ 08081
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
JONES, KEVIN (PHARM TECH)
734 STERLING STREET
PLAINFIELD, NJ 07062
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/22/2017 |
|
JONES, MICHELLE N.
446 PROSPECT STREET-B16
LAKEWOOD, NJ 08701
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/30/2005 |
11/25/2019 |
JONES, ROSALIN (CHHA)
159 PFEIFFER STREET
CAMDEN, NJ 08105
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
JONES, VANESSA (CHHA)
156 NORTH 18TH STREET
EAST ORANGE, NJ 07017
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/17/2018 |
|
JONES-HATTOH, CHATIQUA (CHHA)
3 ROANOKE AVENUE, APT. 2C
NEWARK, NJ 07108
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/23/2018 |
|
JONES-PRICE, ANTIONETTE
PO BOX 1006
WENDELL, NC 27591
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/2000 |
Permanent |
JONES-PRICE, ANTOINETTE
120 S. 20TH STREET
IRVINGTON, NJ 07111
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
3/16/1998 |
Permanent |
JOO, EUI D. (MD)
29 TIP TOP WAY
BERKELEY HGHTS, NJ 07922
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/14/1985 |
Permanent |
JORDAN, SANDRA (LPN)
15 CANIS COURT
SEWELL, NJ 08080
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/5/2017 |
|
JOSE, DELIA V.
185 S.EUCLID ST, SUITE 111
PASADENA, CA 91101
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/22/1997 |
|
JOSEPH, ALEX (CHHA)
1531 SEWALL AVENUE, #2
ASBURY PARK, NJ 07712
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/26/2018 |
|
JOSHI, JAYENDRA B.
95-05 37TH AVE., APT 1-A
JACKSON HEIGHTS, NY 11373
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/4/1997 |
Permanent |
JOSHI, KAJALBEN (LPN)
476 EBONY TREE AVENUE
GALLOWAY, NJ 08205
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/12/2018 |
7/29/2024 |
JOY, RENEE (RN)
34 LUTHER ALLEN LANE
BRUSH CREEK, TN 38547
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/16/2017 |
|
JOYNER, VALERIA (CHHA)
19 SCHIRRA DRIVE
WANAQUE, NJ 07465
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/18/2018 |
|
JUDGE, SCHREATHA R. (CHHA)
49 WALNUT STREET
WOODBURY, NJ 08096
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2023 |
|
JUISTON, PEGGY A.
17 MYRTLE AENUE
IRVINGTON, NJ 07111
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/5/2000 |
Permanent |
JUNGER, SYLVAIN S. (MD)
270 PENNINGTON AVENUE
PASSAIC, NJ 07055
NPI-1497975551 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/20/2011 |
|
JUPITER, RONALD (DDS)
119 EYLAND AVENUE
SUCCASUNNA, NJ 07876
NPI-1023125879 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/5/2014 |
|
JUPITER, RONALD (DDS)
111 EAST DEWEY AVENUE APT 365
WHARTON, NJ 07885
NPI-1023125879 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/15/2016 |
|
JURGENSON, THEODORE W. (DPM)
438 BROADWAY
LONG BRANCH, NJ 07746
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
DECEASED |
JYAMFI, CHARLES (RPH)
71 OLD SHORT HILLS ROAD
WEST ORANGE, NJ 07052
NPI- |
Medical
Contingent Fees |
Suspension Human Services
Medical Assistance (Medicaid) |
3/22/2006 |
|
KACHADOURIAN, ANISE A. (MD)
2233 MORRIS AVENUE, SUITE B-206
UNION, NJ 07083
NPI-1205861861 / 1750349395 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/21/2023 |
|
KACZKA, GARY (RPH)
176 OXFORD AVENUE
SADDLE BROOK, NJ 07663
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
4/30/2024 |
|
KAHF, AHMAD (MD)
401 HALEDON AVENUE
HALEDON, NJ 07508
NPI-1922069517 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/12/2023 |
|
KAHONU, ANNE N.
315 MILL ST.
S. PLAINFIELD, NJ 07080
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
1/19/2013 |
|
KAJI, VIKRAM (MD)
310 COVE LANE
BEACH HAVEN, NJ 08008
NPI-1346326634 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/10/2019 |
Permanent |
KALFUS, DENIS H. (DPM)
1015 EAST GLEN AVE.
WASHINGTOWN TWP, NJ 07606
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/19/2003 |
DECEASED |
KALINOSKI, STEPHEN (RPH)
178 KINGFISHER DRIVE
MIDDLETOWN, NJ 07748
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2018 |
|
KALINOWSKI, KAROL (RN)
31 COVINGTON LANE
VOORHEES, NJ 08043
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/28/2017 |
11/18/2019 |
KALLEN, HERBERT
274 RIVER ROAD
ST JAMES ISLAND, NY 11780
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
KALRA, RITESH (MD)
38 CREEKSIDE COURT #38
SECAUCUS, NJ 07094
NPI-1043436348 / 1114235058 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/11/2025 |
|
KAMARA, HELEN H. (CHHA)
P.O. BOX 509
PALMYRA, NJ 08065
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2002 |
|
KANATSOULIS, GIORGIA (CHHA)
470 PIAGET AVENUE, APT. K6
CLIFTON, NJ 07011
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2023 |
|
KANE, TINA (APN/RN)
157 EVERGREEN AVENUE
VILLAS, NJ 08251
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/9/2019 |
|
KANEVSKY, ZHANNA (MD)
28 KEPPEL AVENUE #10307
STATEN ISLAND, NY 10307
NPI-1073551065 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/4/2014 |
Permanent |
KANG, BYUNG (MD)
122 LONG HILL ROAD
LITTLE FALLS, NJ 07424
NPI-1164599213 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/23/2016 |
|
KANIA, RAMESHCHAN (MD)
310 CENTRAL AVE SUITE 10
EAST ORANGE, NJ 07018
NPI-1235158403 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
2/22/2012 |
10/3/2019 |
KANIA, RAMESHCHAN (MD)
310 CENTRAL AVE STE. 106
EAST ORANGE, NJ 07018
NPI-1235158403 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/20/2014 |
10/3/2019 |
KANKAM, MARTIN
13 G READING RD.
EDISON, NJ 07083
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/30/2005 |
|
KANZ JR., JOHN T. (RPH)
136 HILLCREST AVENUE
HILLTOP, NJ 07542
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/17/1984 |
Permanent |
KAPLAN, DONALD (DPM)
701 PALMER AVENUE
ALLENHURST, NJ 07711
NPI-1952433567 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
3/25/2010 |
|
KAPLAN, HARMON B. (DDS)
1251 PATERSON PLANK RD.
SECAUCUS, NJ 07094
NPI-1093991044 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/26/1988 |
Permanent |
KARASEK, ROBERT D. (DMD)
64 DOCKSIDE DRIVE
SOMERS POINT, NJ 08244
NPI-1689794042 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/19/2016 |
|
KARASEK, ROBERT D. (DMD)
559 PLAINFIELD AVENUE
BERKELEY HEIGHT, NJ 07922
NPI-1689794042 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2014 |
|
KARES, FRANCES (RPH)
615 SUMMIT ROAD
UNION, NJ 07083
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/16/1983 |
2/16/1991 |
KARFUNKEL, DAVID M.
100 HOWARD AVENUE
PASSAIC, NJ 07055
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/2/2008 |
10/25/2013 |
KARGBO, DORA (LPN)
861 N. OAKLAND AVENUE
RUNNEMEDE, NJ 08078
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/2025 |
2/26/2026 |
KARGE, FREDRICK
PO BOX 190
AVENEL, NJ 07001
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/28/2007 |
|
KARLEWICA, ERIC aka MAZZA, ANTHONY
353 S. PASCACK ROAD
SPRING VALLEY, NY 10977
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/11/2024 |
|
KARNER, ANNA (EMT)
17 MAPLE AVENUE
PINE BROOK, NJ 07058
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/23/2002 |
|
KARSHENBOYM, ALEXANDER
90 WEST HILL ROAD
WOODCLIFF LAKE, NJ 07677
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
9/20/2007 |
|
KATTUPALLI, GERONAMI (MD)
175 BARRENS COURT, SUITE 100
PORT MATILDA, PA 16870
NPI-1992901433 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/15/2022 |
|
KAUFMAN, SHOSHANA AKA STOKELBERG, SHOSHANA (LCSW)
349 JESTER COURT
OLD BRIDGE, NJ 08857
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/15/2009 |
11/7/2014 |
KAUL, RICHARD (MD)
292 ATLANTIC STREET
HACKENSACK, NJ 07601
NPI-1902838790 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/1/2014 |
|
KAVROS, STEVEN J. (DPM)
12 HERITAGE COURT
CHERRY HILL, NJ 08034
NPI-1316912801 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
8/22/2019 |
KAWAN JABAKJI, MOHAMED (MD)
160 HALEDON AVENUE
PROSPECT PARK, NJ 07508
NPI-1760541312 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/16/2016 |
|
KAWAN JABAKJI, MOHAMED (MD)
6 BARKER PLACE
WAYNE, NJ 07470
NPI-1760541312 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2017 |
|
KAY, KWAME (CHHA)
PO BOX 961186
MIAMI, FL 33296
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
KEE, TERRAYA C. (CHHA)
CLINTON STREET
CAMDEN, NJ 08105
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/30/2007 |
Permanent |
KEELEN, SUSAN (RN)
272 OLD YORK ROAD
FLEMINGTON, NJ 08822
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2001 |
1/27/2012 |
KEENEY, RICHARD (DC)
112 BALTIMORE STREET
HANOVER, PA 17331
NPI-1255461430 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2015 |
|
KELADA, RINIH (CHHA)
132 W 9TH STREET, APT. 1F
BAYONNE, NJ 07002
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/5/2023 |
|
KELLEY, JANINE (RN)
126 S. LECATO AVENUE
AUDOBON, NJ 08106
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/2/2018 |
Permanent |
KELLOGG, WILLIAM T. (MD)
47 MAPLE STREET, STE. 204
SUMMIT, NJ 07901
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/9/1996 |
2/28/2014 |
KELLUM, BETZAIDA (CHHA)
1936 S. 8TH STREET, APT. B13
CAMDEN, NJ 08104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
KELLUM, EARLENE (CHHA)
279 S. BLACKHORSE PIKE
MOUNT EPHRAIM, NJ 08059
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/5/2018 |
3/11/2024 |
KELLY, MICHELLE
963 PARK AVENUE
PLAINFIELD, NJ 07060
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/24/2002 |
|
KELLY-UPPER, DENISE
2200 ATLANTIS AVENUE
MAYS LANDING, NJ 08330
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
KEMENY, GEORGE (MD)
39 THIRD STREET
ELIZABETH, NJ 07206
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/22/1977 |
Permanent |
KEMOKAI, JOSEPHINE (LPN)
29 BENNETT AVENUE
RANDOLPH, NJ 07869
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/21/2016 |
|
KENDRICK, SOPHIA (CHHA)
4 OAK WALK
CAMDEN, NJ 08104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/17/2018 |
|
KENNEALLY, CHRISTOPHER (RN)
1308 NOREEN DRIVE
BURLINGTON, NJ 08016
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/30/2019 |
10/21/2025 |
KENNEDY, SHANELYN
50 N. GARFIELD AVE, APT B
SCRANTON , PA 18504
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/5/2024 |
|
KENNETT, SHAR (MD)
65 HECTOR ROAD
MORRIS PLAINS, NJ 07950
NPI-1225027568 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/22/2024 |
Permanent |
KEREKES, KEVIN #65504-050
FCI SCHUYKILL, PO BOX 759
MINERSVILLE, PA 17954
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/1/2019 |
|
KESHISHIAN, PAUL (DO)
625 COBH ROAD
RIVER VALE, NJ 07675
NPI-1437207610 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/22/1999 |
3/15/2000 |
KEYES, DONNA (CHHA)
4433 EAST MILLS ROAD
MAPLE SHADE, NJ 08052
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
KHAIMOV, SAMUEL (RPH)
3 NORGATE ROAD
GLEN HEAD, NY 11545
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/11/2024 |
|
I & I INVALID COACH, INC.
85 CENTRAL AVENUE
CLIFTON, NJ 07015KHAIR, IMADELIN A.
160 ALABAMA AVENUE
PATERSON, NJ 07505
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
1/28/2001 |
|
KHAIR, IMADELIN A.
FORT DIX FCI, PO BOX 2000
JOINT BASE MDL, NJ 08640
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/24/2017 |
|
KHAJAVI, ABDOLALI (MD)
HIGHWAY 94 & OSBOW LANE
FRANKLIN, NJ 07416
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/20/1999 |
Permanent |
KHAMIS, HEBA (CHHA)
117 TONNELE AVENUE, APT. 5
JERSEY CITY, NJ 07306
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2023 |
|
KHAN, ASIF ALI
909A BROAD STREET
NEWARK, NJ 07102
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
6/5/1996 |
Permanent |
KHAN, AYSHA (RPH)
116 BOONTON AVENUE
KINNELON, NJ 07405
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
2/23/2024 |
|
S. BROTHERS PHARMACY, INC.
687 FRELINGHUYSEN AVENUE
NEWARK, NJ 07114KHAN, AZAM HYAT
687 FRELINGHUYSEN AVENUE
NEWARK, NJ 07114
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/16/1998 |
|
S. BROTHERS PHARMACY, INC.
687 FRELINGHUYSEN AVENUE
NEWARK, NJ 07114KHAN, AZAM HYAT
687 FRELINGHUTSEN AVENUE
NEWARK, NJ 07114
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/21/1999 |
Permanent |
KHAN, AZAM HYAT
107 CHARLESTON AVENUE
STATEN ISLAND, NY 10309
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/7/2008 |
|
KHAN, MUNIR
238 GRAND ST. APT. 1
JERSEY CITY, NJ 07302
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
8/20/2009 |
Permanent |
KHAN, SALEEM M.
336 2ND ST. APT.1
JERSEY CITY, NJ 07302
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/20/2003 |
|
KHAN, TAUQIR
71 HEALTH COURT
PENNINGTON, NJ 08534
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/1/2024 |
|
KHAN, TAUQIR
P.O. BOX 420
FAIRTON, NJ 08320
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
7/20/2010 |
8/9/2010 |
KHAN, TAUQIR
P.O. BOX 420
FAIRTON, NJ 08320
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/9/2010 |
|
KHANDWALA, NITIN (RPH)
225 MILLBURN AVENUE
MILLBURN, NJ 07041
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/21/1999 |
11/29/2012 |
KHAN-JAFFREY, KRANIZ (MD)
1127-1129 N. NEW ROAD, SUITE 102
ABSECON, NJ 08201
NPI-1629143979 / 1396131025 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/15/2021 |
|
KHANNA, YASH (MD)
310 CENTRAL AVENUE
EAST ORANGE, NJ 07018
NPI-1093805012 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/30/2014 |
|
KHANNA, YASH K. (MD)
825 BLOOMFIELD AVE ST L1
VERONA, NJ 07044
NPI-1093805012 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
2/22/2012 |
|
KHANTHAN, SUBRAMANIAM (MD)
327 SCHUYLER AVENUE
KEARNY, NJ 07032
NPI-1003882663 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2019 |
|
VIP CARE, INC.
49 GATES COURT
MATAWAN, NJ 07747KHAPCHIK, DMITRY
49 GATES COURT
MATAWAN, NJ 07747
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/10/2019 |
|
KHARKOVER, ALEKSANDR (PT)
FCI FORT DIX PO BOX 2000
FORT DIX, NJ 08640
NPI-1861594889 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2013 |
|
KHAWLY, MARY THERESA
333 FERN STREET, APT. 715
WEST PALM BEACH, FL 33401
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/5/2025 |
|
KHURANA, NORENDRA
32 ROLLING HILLS LANE
HARRISON, NY 10528
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
KIBALLO, MARIAN B. (RN)
4 OJIBWA COURT
WARETOWN, NJ 08758
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/18/2003 |
|
KIKTA, DANUTA (RN)
593 GREENWICH COURT
HIGHTSTOWN, NJ 08520
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/25/2019 |
|
KILLEN, DAWN (LPN)
804 COTSWOLD ROAD
SOMERDALE, NJ 08083
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2006 |
|
KILLMEYER, LINDA (RN)
875 QUAKER CHURCH ROAD
PERRYOPOLIS, PA 15473
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2015 |
|
KIM, DOYOUN (MD)
2302 BAY HEAD DRIVE
PARLIN, NJ 08859
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/13/1999 |
Permanent |
KIM, DOYOUN (MD)
545 KEARNY AVENUE
KEARNY, NJ 07032
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/30/1998 |
|
KIM, JENNIFER J. (RPH)
1117 INWOOD TERRACE
FORT LEE, NJ 07024
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/23/2003 |
7/12/2022 |
KIMBLE, SABRINA
341 OSBOURNE TERRACE, 2C
NEWARK, NJ 07106
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/23/2009 |
|
KIMMEL, STEVEN (CONTRACTS MANAGER)
420 DELAWARE ST.
MINNEAPOLIS, MN 55455
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/1/2002 |
|
KINDER, EDWARD P.
5180 LA TERRA AVE.
PAHRUMP, NV 89061
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
7/17/2009 |
7/17/2014 |
KING, DEBORAH AKA BENTON, DEBORAH (LPN)
9 RADFORD PLACE
WILLINGBORO, NJ 08046
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/18/2001 |
11/5/2018 |
KING, JOHN ANDERSON (DO)
11310 S. ORANGE BLOSSOM
ORLANDO, FL 23837
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/20/2007 |
|
KING, STEVEN
228 S. MAIN STREET
CRESCENT CITY, FL 32112
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2024 |
|
KING, WILLIAM (MD)
LEWISBURG USP, PO BOX 1000
LEWISBURG, PA 17837
NPI-1457411670 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2010 |
|
KIRWIN, SHANNON (RN)
114 NORTHMONT AVENUE
MOUNT EPHRAIM, NJ 08059
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/18/2007 |
|
KISSAM, JEFFREY
1506 RUSTIC DRIVE
OCEAN TOWNSHIP, NJ 07712
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/28/1992 |
Permanent |
KLAUMENZER, JANE (RN)
8 TENNESSEE AVENUE
LONG BEACH TWP., NJ 08008
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/20/2003 |
|
KLAUSNER, MARC (RPH)
4515 BERGENLINE AVENUE
UNION CITY, NJ 07087
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/29/1999 |
|
KLAUSS, GUNNAR (MD)
30 PROSPECT AVENUE
HACKENSACK, NJ 07601
NPI-1962685305 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/1/2014 |
6/22/2017 |
KLEES, DAVID (DO)
1527 LINWOOD AVENUE
ERIE, PA 16510
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
KLEINER, MITCHELL (LCSW)
108 SHINNECOCK DRIVE
MANALAPAN, NJ 07726
NPI-1316416662 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/8/2022 |
Permanent |
KLEINMAN, MARSHA (PSYCH
32 NORTH 7TH AVENUE
HIGHLAND PARK, NJ 08904
NPI-1043332893 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/4/2012 |
|
KLEINMAN, MARVIN (AUDIOLOGIST)
1 CLARIDGE DRIVE, APT. 508
VERONA, NJ 07044
NPI-1609995307 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/11/2016 |
|
KLEMONS, IRA (DDS)
23 DEERPATH LANE
COLTS NECK, NJ 07722
NPI-1841393386 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/7/2017 |
|
KLEYDMAN, YEKATERINA (DO)
2960 OCEAN AVENUE, 2ND FLOOR
BROOKLYN, NJ 11235
NPI-1740589258 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/20/2022 |
|
KLEYMAN, VLADIMIR (RPH)
3 CATHEDRAL DRIVE
LAKEWOOD, NJ 08701
NPI-1386957710 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/23/2016 |
|
KLEYMAN, VLADIMIR #66307-050 (RPH)
FCI-OTISVILLE, PO BOX 1000
OTISVILLE, NY 10963
NPI-1386957710 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/12/2016 |
|
KMET, BOGDAN
363 EAST ROOSEVELT BOULEVARD
PHILADELPHIA, PA 19120
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
KMET, NAZARIY
2284 SANTRAP ROAD
JAMISON, PA 18929
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
KMET, ROSTISLAV
13021 BLAKESLEE DRIVE, APT. A
PHILADELPHIA, PA 19116
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
KOBYLECKYJ, CRYSTYNA (RN)
35 WOODCOCK MOUNTAIN ROAD
WASHINGTONVILLE, NY 10992
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/29/2017 |
|
KOCH, MARK (DO)
336 BARNES ROAD
MONROEVILLE, AL 36460
NPI-1528102647 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
9/24/2025 |
KOGAN, VADIM (RN)
56 NORMANDY DRIVE
PRINCETON JUNCT, NJ 08550
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/18/2003 |
|
KOHFELDT, LISA (RN)
242 WEST FRONT STREET, APT. 2
FLORENCE, NJ 08518
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/7/2019 |
|
KOLLMER, W. LANCE (MD)
101 OLD SHORT HILLS ROAD
WEST ORANGE, NJ 07052
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/18/2001 |
DECEASED |
KONIG, ESTHER
324 HIALEAH DRIVE
CHERRY HILL, NJ 08002
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/10/2025 |
|
KONIG, ESTHER
324 HIALEAH DRIVE
CHERRY HILL, NJ 08002
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/10/2025 |
|
KONIG, ESTHER
181 BEACH 135TH STREET, APT 1
ROCKAWAY PARK, NY 11694
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2025 |
|
KONIG, MICHAEL
1125 MAXWELL LANE
HOBOKEN, NJ 07030
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/10/2025 |
|
KONIG, MICHAEL
1125 MAXWELL LANE
HOBOKEN, NJ 07030
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/10/2025 |
|
KONIG, MICHAEL
181 BEACH 135TH STREET, APT 1
ROCKAWAY PARK, NY 11694
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2025 |
|
KONIG, ROBERT
67 WOODMERE BLVD. SOUTH
WOODMERE, NY 11598
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/10/2025 |
|
KONIG, ROBERT
67 WOODMERE BLVD S.
WOODMERE, NY 11598
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2025 |
|
KONNY, GREGORY (RPH)
990 CROMWELL ROAD
WOODMERE, NY 11598
NPI-1396926432 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/18/2021 |
|
KONTOS, DEMETRIUS D. (MD)
463 TENAFLY ROAD
ENGLEWOOD , NJ 07631
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/20/2000 |
|
KOPLITZ, MARSHALL
256 NORWOOD AVENUE
DEAL, NJ 07723
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/10/1999 |
|
KORNAK, PAUL H. (MD)
ELKTON FCI, BOX 10
LISBON, OH 44432
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/19/2007 |
|
KOSLOV, GLEB M. (DC)
388 RAMAPO VALLEY ROAD
OAKLAND, NJ 07436
NPI-1366584583 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
KOTHALANKA, SITARAMAKRISHNA (MD)
562 SW ROMORA BAY
PORT LUCIE, FL 34986
NPI-1184644080 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/25/2016 |
|
KOTTURI, SHIVA (MD)
512 KEARNY AVENUE, SUITE B
KEARNY, NJ 07032
NPI-1013168251 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/17/2018 |
Permanent |
KOUSOULIDES, LOUISE (RN)
34 TOPANEMUS LANE, APT. 14
FREEHOLD, NJ 07728
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/20/2009 |
|
KOUZMA, NATALIA (CHHA)
122 CHELSEA WAY
BRIDGEWATER, NJ 08807
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
KOVAR, GRACE M. (RN)
929 CHELSEA DRIVE
BRICKTOWN, NJ 08724
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/19/2005 |
|
KOWALENKO, THOMAS A (DO)
880 RARITAN ROAD
CLARK, NJ 07066
NPI-1538136429 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/10/2021 |
1/19/2023 |
KOWNACKY, MEGAN (RN)
622 WALDEN WAY
LUMBERTON, NJ 08048
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/28/2017 |
|
KOZIUPA, HELENE A. (LPN)
64 WESLEYAN DRIVE
TRENTON, NJ 08690
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2002 |
|
KRACKE, BARBARA (LPN)
44 COVINGTON COURT
EAST BRUNSWICK, NJ 08816
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/13/2018 |
2/19/2025 |
KRAEMER, LINDA (LPN)
436 SAINT ANDREW PLACE
MANALAPAN, NJ 07726
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/19/2006 |
|
KRAKAUER, RANDALL (MD)
900 W MAIN ST
FREEHOLD, NJ 07728
NPI-1588811012 |
Medical
Poor Performance |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/25/1985 |
|
KRAMER JR., EDWARD (DC)
106 MOTT ROAD
BLAIRSTOWN, NJ 07825
NPI-1285762401 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/28/2017 |
Permanent |
KRAMER, LARRY S. (RPH)
650 PALISADES AVE
ENGLEWOOD CLIFF, NJ 07632
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/10/2003 |
|
KRAUS, C.R. a/k/a CHRISTOPHER KRAUS
10 S. MAIN STREET, APT 2A
MANVILLE, NJ 08835
NPI- |
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/26/2024 |
|
KRAUS, CHRISTOPHER a/k/a C.R. KRAUS
10 S. MAIN STREET, APT 2A
MANVILLE, NJ 08835
NPI- |
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/26/2024 |
|
KRAUSMAN, STEVEN
7 ROLLING HILL LANE
LAWRENCE , NY 11559
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/10/2025 |
|
KRAUSMAN, STEVEN
7 ROLLING HILL LANE
LAWRENCE , NY 11559
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/10/2025 |
|
KRAUSMAN, STEVEN
7 ROLLING HILL LANE
LAWRENCE, NY 11559
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2025 |
|
KREISMAN, MARCIA
8800 BOULEVARD EAST, APT. 6J
NORTH BERGEN, NJ 07047
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/20/2004 |
Permanent |
KRESKI, CHRISTINA (RN)
2667 PAXTONVILLE ROAD
MIDDLEBURG, PA 17842
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2015 |
|
KRICHEVSKY, RITA (MD)
4429 DRIFTWOOD DRIVE
PHILADELPHIA, PA 19129
NPI-1851561963 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2017 |
|
KRICHEVSKY, RITA (MD)
712 KEEFE ROAD
LAWRENCEVILLE, NJ 08648
NPI-1851561963 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/26/2019 |
|
KRIVOSHIK, MARK (MD)
16 YEGER DRIVE
ALLENTOWN, NJ 08501
NPI-1669409306 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
10/27/2020 |
KROHN, IVAN T. (MD)
33 NORTHWOOD DRIVE
VINELAND, NJ 08360
NPI-1467429258 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
5/20/2012 |
|
KROHN, IVAN T. (MD)
33 NORTHLAND DRIVE
VINELAND, NJ 08360
NPI-1467429258 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/20/2011 |
|
KROMAH, ANGIE (RN)
3206 LAWNDALE DRIVE EAST
GREENSBORO, SC 27408
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2017 |
|
KROWICKI, JENNIFER B. AKA GRASSER, JENNIFER (RN)
232 CLUB DRIVE
WALL, NJ 07719
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2002 |
|
KRUTYOYARSKY, IRINA #65107-050
ALDERSON FEDERAL PRISON, GLEN RAY ROAD, BOX A
ALDERSON, WV 24910
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/12/2016 |
|
KRYSIAK, KIMBERLY (LPN)
766 DUNEDIN STREET
TOMS RIVER, NJ 08753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/11/2023 |
|
KUAN, JENG K. (CHIROPRACTOR)
11 EDGEWOOD ROAD
MATAWAN, NJ 07747
NPI-1962662288 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/16/2024 |
|
KUBACKI, JOSEPH (MD)
PO BOX 3949
PENSACOLA , FL 32516
NPI-1306834213 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
5/20/2013 |
|
KUBLIN, ANNE (MD)
182 WHALEPOND ROAD
EATONTOWN, NJ 07724
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
3/19/2004 |
|
KUDLA, ALEXANDER
1449 LLOYD TERRACE
MILLVILLE, NJ 08332
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/18/2019 |
|
KUKASH, ABIGAIL
6648 WEXFORD AVENUE
RICHMOND, VA 23255
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
KUKASH, MAJDI AKA MIKE
87-02 PENNSBURY PLACE
RICHMOND, VA 23255
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
KUKREJA, NAV R. AKA KUKREJA, NAVRAJAN (MD)
1331 COVENTRY COURT
ISELIN, NJ 08830
NPI-1295739662 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/15/2016 |
|
KULYK, ODARKA (CHHA)
6 COLBY COURT
LINCOLN PARK, NJ 07035
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
KUMAR, ANIL
184 OLD BEEKMAN ROAD
MONMOUTH JUNCT., NJ 08852
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/14/2005 |
Permanent |
KUMAR, SAROJ
184 OLD BEEKMAN ROAD
MONMOUTH JUNCT., NJ 08852
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/14/2005 |
Permanent |
KUNZ, BARBARA (RN)
55 THIRD STREET
NEW YORK, NY 10956
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/21/2018 |
10/21/2021 |
KUNZ, BARBARA (RN)
55 THIRD STREET
NEW CITY, NJ 10956
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/16/2023 |
|
KURAN, BASSEM
FCI FAIRTON, PO BOX 420
FAIRTON, WV 08320
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/7/2017 |
|
KURBAN, HAKAN
41 SIDNEY AVENUE
RUTHERFORD, NJ 07070
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/22/1999 |
Permanent |
KURIAN, LISSYAMMA (RN)
1253 COLLIDGE AVENUE
UNION, NJ 07083
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2002 |
|
KURIS, JAY (MD)
160 MONTDALE DRIVE
PRINCETON , NJ 08540
NPI-1003997453 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/18/2019 |
|
KURLANDER-ZAKARIA, TRACI (RN)
20 ROCK ROYAL ROAD
TRENTON, NJ 08620
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/26/2010 |
|
KURTZ, JOEL P. (DMD)
9 WESTGATE ROAD
LIVINGSTON, NJ 07039
NPI-1285874743 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/19/2005 |
|
KURTZER, BARRY a/k/a YITZCHOCK KURTZER (MD)
11 GOLAR DRIVE
MONSEY, NY 10952
NPI-1154321891 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/14/2025 |
|
KURTZER, ROBIN
11 GOLAR DRIVE
MONSEY, NY 10952
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/14/2025 |
|
KURTZER, YITZCHOCK a/k/a BARRY KURTZER (MD)
11 GOLAR DRIVE
MONSEY, NY 10952
NPI-1154321891 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/20/2024 |
|
KURTZER, YITZCHOCK a/k/a BARRY KURTZER (MD)
11 GOLAR DRIVE
MONSEY, NY 10952
NPI-1154321891 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/14/2025 |
|
KUSHMAN, JOSEPH (MD)
224 COLONIAL AVENUE
UNION, NJ 07083
NPI-1205025541 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/28/2017 |
|
KUSHNER, ALAN (DC)
SCI GRATERFORD, JG1165, PO BOX 244
GRATERFORD, PA 19426
NPI-1558398396 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
KUYINU, MICHAEL (MD)
24 VANDERVEER DRIVE
BELLE MEAD, NJ 08502
NPI-1235173568 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/16/2015 |
|
KYMER, RHIANNON (ROOSMA) (RN)
8 SPENCER LANE
WARREN, NJ 07059
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/27/2018 |
|
LABORDE, JAMES (DC)
329 SOUTH HIGHLAND STREET
DUBOIS, PA 15801
NPI-1578541504 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
LABOY, MICHELLE (LPN)
71 LYCEUM COURT
STATEN ISLAND, NY 10310
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2017 |
11/2/2017 |
LABRUNA, VINCENT A. (DDS)
227 EAST 19TH STREET
NEW YORK, NY 10003
NPI-1801192216 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/22/2002 |
1/29/2018 |
LABRUNA, VINCENT A. (DDS)
EAST 19TH STREET
NEW YORK, NY 10003
NPI-1801192216 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2002 |
1/29/2018 |
JRL HEALTH ASSOC., LTD
479 INNES ROAD
WOODBRIDGE, NJ 07075LACEY, JOAN R. (RN)
479 INNES ROAD
WOODRIDGE, NJ 07075
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/19/2000 |
|
LACRICCHIO, RICHARD C.
150 ROUTE 150
DENVILLE, NJ 07834
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
LAFON, MICHAEL (MD)
107 E. MANTUA AVE.
WENONAH, NJ 08090
NPI-1609168715 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/28/2004 |
2/16/2015 |
LAGRADA, WILLIAM (MD)
1300 MAIN STREET, STE2D
CLIFTON, NJ 07011
NPI-1316996762 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
2/15/2012 |
9/25/2014 |
LAGRADA, WILLIAM (MD)
15 FORSYTHIA DRIVE
EDISON, NJ 08837
NPI-1316996762 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
9/25/2014 |
|
LAGUERRE, JEAN EDWARD (RPH)
1 62ND STREET APT 4C
W. NEW YORK, NJ 07093
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/16/2007 |
|
LAGUERRE, JEAN EDWARD (RPH)
1 62ND STREET APT 4C
WEST NEW YORK, NJ 07093
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/29/2008 |
|
LAI, MYUNG-OK (RN)
40 PONY LANE
FLEMINGTON, NJ 08822
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/13/2018 |
6/27/2019 |
LAIDO, JOSEPH (CHHA)
722 SIXTH STREET
LYNDHURST, NJ 07071
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
LAJEWSKI, WAYNE (MD)
FCI FORT DIX, PO BOX 2000
JOINT BASE MDL, NJ 08640
NPI-1558364166 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/20/2015 |
4/7/2025 |
LALAJI, ANAND (MD)
4532 DUDLEY LANE
ATLANTA, GA 30327
NPI-1649245747 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/19/2024 |
|
LALLEMAND JR., ROGER (MD)
4 TYCOR COURT
HOLMDEL, NJ 07733
NPI-1770575821 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/20/2014 |
|
LAM, MICHAEL CHUNG KAY (MD)
28TH STREET
ENGLEWOOD CLIFF, NJ 07632
NPI-1184656050 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/14/2014 |
|
LAM, MICHAEL CHUNG KAY (MD)
1625 ANDERSON AVE
FORT LEE, NJ 07024
NPI-1184656050 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
3/6/2014 |
|
LAMBRIOLA, VINCENT P. (DDS)
143 LITTLE FALLS
CEDAR GROVE, NJ 07009
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2001 |
Permanent |
LaMONACA, TARA ANNE (LSW)
211 BELHAVEN AVENUE
LINWOOD, NJ 08221
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2022 |
|
LAMP, REBECCA (RN/CNP)
139 DERWOOD DRIVE
NEW CUMBERLAND, WV 26407
NPI-1568511236 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
LAMPARELLI, NICHOLAS (RPH)
149 SUMMIT AVENUE
ISLAND HEIGHTS, NJ 08732
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/30/2003 |
Permanent |
LAMPHIER, JENNIFER (DMD)
38 SILVERSIDE ROAD
LAKEWOOD, NJ 08701
NPI-1487860649 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/23/2019 |
|
LAMPROU JR., EMANUEL (MD)
509 N. BROAD ST.
WOODBURY, NJ 08096
NPI-1033104526 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
12/18/2012 |
12/18/2015 |
LAMPROU JR., EMANUEL (MD)
300 TAVISTOCK
CHERRY HILL, NJ 08034
NPI-1033104526 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/8/2025 |
Permanent |
LANCE-LANNIGAN, JUDITH
12 PROSPECT HILL
FLEMINGTON, NJ 08822
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/23/2010 |
DECEASED |
LANDOLFI (LANDOLPHI), CHRISTINA (LPN)
659 HERITAGE ROAD
SEWELL, NJ 08080
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/27/2021 |
|
LANDOU, LISSA S. (DC)
17B 16TH AVENUE
EMLMWOOD PARK, NJ 07407
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/18/2002 |
|
LANE, EDWIN (MD)
BEACHWOOD BOULEVARD
BEACHWOOD, NJ 08722
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
DECEASED |
LANG, ANTHONY
151 SOUTH DURAND PLACE
IRVINGTON, NJ 07111
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/19/2009 |
10/19/2014 |
LANG, BRIAN E. (LPN)
634 SPROUL STREET
CHESTER, PA 19013
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/20/2006 |
|
LANG, DEBRA (CHHA)
124 VAN BUSKIRK ROAD
TEANECK, NJ 07666
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2002 |
|
LANGERAAP, JOHN (DC)
198 WHITE LAKE ROAD
LAFAYETTE, NJ 07848
NPI-1720299092 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/26/2018 |
|
LANGERAAP, JOHN (DC)
289 WEST MOUNTAIN ROAD
SPARTA, NJ 07871
NPI-1720299092 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/12/2020 |
|
LANGLIEB, MARTIN S. (DDS)
0-94 MIDLAND AVENUE
FAIRLAWN, NJ 07410
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/25/1999 |
Permanent |
LANNON, JENNIFER (RN)
520 COLLINGS AVENNUE
COLLINGSWOOD, NJ 08108
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/4/2018 |
|
LAPIDES, DAVID (MD)
3772 BUCK ISLAND ROAD
CHARLOTTESVILLE, VA 22902
NPI-1255774311 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/5/2023 |
Permanent |
LAPIDES, DAVID (MD)
3772 BUCK ISLAND ROAD
CHARLOTTESVILLE, VA 22902
NPI-1255774311 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/19/2023 |
|
LAPORTE, EDYNE (RN/LPN)
1107 FURTH ROAD
VALLEY STREAM, NY 11581
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/27/2007 |
|
LASHKEVICH, JOHN P.
9 CHARLES LANE
CHERRY HILL, NJ 08003
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/8/1998 |
|
LASTIVKA, MARTA (CHHA)
28 WINDING WOOD, APT. 2-B
SAYREVILLE, NJ 08872
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
LASTRA, ABRAHAM
1808 BERGENLINE AVENUE
UNION CITY, NJ 07087
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/20/2010 |
|
LASTRA, ABRAHAM
500 HIGHLAND AVENUE
NEWARK, NJ 07102
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/15/1999 |
Permanent |
LATAWIEC, ANDREA (RN)
1681 RARITAN ROAD
CLARK, NJ 07066
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2002 |
|
LATCHMAN, BHANWATIE (PHARM TECH)
76 WATSON AVENUE
EAST ORANGE, NJ 07052
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/16/2016 |
|
LAUGHLIN JR., DAVID C.
22024 W. TONTO STREET
BUUCKEYE, AZ 85326
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/9/2024 |
|
LAURIA, SHANNON (CHHA)
86 FORT DE FRANCE AVENUE
TOMS RIVER, NJ 08757
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/7/2017 |
|
LAURITANO, LAURA (RN)
47 OLD ORCHARD COURT
CEDAR GROVE, NJ 07009
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/28/2017 |
8/2/2019 |
LAVELLE, BARBARA (RN/APN)
550 LINCOLN AVE.
RIDGEFIELD, NJ 07657
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/18/2003 |
|
LAVINE, LAWRENCE M. (MD)
926 HADDONFIELD ROAD
CHERRY HILL, NJ 08002
NPI-1336119171 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/27/2021 |
|
LAVNEVICH, NAUM (CHHA)
11 HIAWATHA BLVD.
OAKLAND, NJ 07436
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
11/4/2014 |
|
LAVNEVICH, NAUM (CHHA)
11 HIAWATHA BLVD.
OAKLAND, NJ 07436
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/11/2016 |
|
LAZOW, SOLOMON M. (MD)
199 MAIN ST
MATAWAN, NJ 07747
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
LEATHERDALE, LAURA (CHHA)
4 MEETINGHOUSE ROAD
WRIGHTSTOWN, NJ 08562
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2003 |
|
LEBAK, STEPHANIE (APN/RN)
92 EATON ROAD
BORDENTOWN, NJ 08505
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/29/2019 |
8/30/2022 |
LEE JR., SAMUEL (RPH)
34 PINAFORE LANE
WILLINGBORO, NJ
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/30/1997 |
Permanent |
LEE, AUGUSTINE (MD)
PO BOX 329002
BROOKLYN, NY 11232
NPI-1255478269 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
10/29/2013 |
|
LEE, AUGUSTINE (MD)
905 STUYVESANT AVENUE
TRENTON, NJ 08618
NPI-1255478269 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
12/22/2011 |
|
LEE, BRIAN (LPN)
1722 COPE STREET
CAMDEN, NJ 08104
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2002 |
8/9/2013 |
LEE, BRIAN (LPN)
1722 COPE STREET
CAMDEN, NJ 08104
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/18/2018 |
5/17/2022 |
LEE, CHANG HO (MD)
535A 7TH STREET
PALISADES PARK, NJ 07650
NPI-1679795181 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2015 |
|
LEE, DAVID (MD)
46 CONSTITUTION DRIVE
SOUTHAMPTON, NJ 08088
NPI-1275633562 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/22/2016 |
Permanent |
LEE, HOE Y. (MD)
30 MOHAWK ROAD, APT 1
SHORT HILLS, NJ 07078
NPI-1043344377 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/5/2023 |
Permanent |
LEE, JANE (MD)
271 TALLY HO ROAD
ARROYO GRANDE, CA 93420
NPI-1962450254 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/5/2025 |
|
LEE, LAURA
7280 LEMINGTON AVENUE
PITTSBURGH, PA 15206
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
LEE, PAMELA (CNM)
141 RED HILL ROAD
PRINCETON, NJ 08540
NPI-1558779413 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/6/2024 |
|
LEE, STEVE Y. (DDS)
1219 MAIN AVENUE
CLIFTON, NJ 07111
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/19/2001 |
|
LEE, SYLVIA S. (MD)
27 SUNSET PLACE
EMERSON, NJ 07630
NPI-1275518490 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
8/26/2013 |
|
LEEDS, GARY (MD)
77 WEST 15TH STREET, APT. 6-H
NEW YORK, NY 10011
NPI-1316005036 |
Medical
Antitrust/Anti-Kickback Acts |
Debarment Human Services
Medical Assistance (Medicaid) |
11/21/2016 |
|
LEEDS, GARY (MD)
16 ELIZABETH LANE
RIVERSIDE, CT 06878
NPI-1316005036 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/24/2017 |
|
LEIBER, CHARLES
5804 BOARDWALK, APT. 104
VENTOR, NJ 08406
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/22/2007 |
|
LEIBMAN, JOSEPH B. (MD)
PO BOX 1005
PORT JERVIS, NY 12771
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/22/2000 |
Permanent |
LEISER, SHAUL (RN)
14 HICKORY HILL ROAD
JACKSON, NJ 08527
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/7/2018 |
6/8/2021 |
LEKWAUWA, CHIKWUEKE (RN)
1643 PARK STREET
RAHWAY, NJ 07065
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/28/2017 |
6/4/2019 |
LEON, JACK
2991 E.CHESTNUT AV UN H80
VINELAND, NJ 08360
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/22/2000 |
Permanent |
LEON SCD UNLIMITED
1071 E. LANDIS AVENUE
VINELAND, NJ 08360LEON, JACK
1071 E. LANDIS AVENUE
VINELAND, NJ 08360
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
6/29/1998 |
|
LEONARD, BARRY A. (MD)
15 DARIEN DRIVE
CHERRY HILL, NJ 08003
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/13/1996 |
Permanent |
LEONARD, JUDITH (RPH)
70 LAUREL DRIVE
LITTLE SILVER, NJ 07739
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/20/2005 |
|
LEONARD, KEREN (RN)
44 COCHISE CIRCLE
MEDFORD, NJ 08055
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/25/2023 |
|
LEONARD, TROY (COUNSELOR)
999 COLONIAL ROAD
FRANKLIN LAKES, NJ 07417
NPI-1851691448 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/22/2016 |
Permanent |
LEONARDINI, BORIS (CHHA)
44 WEST 53RD STREET
BAYONNE, NJ 07002
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/29/2024 |
|
LEPKO, ERVIN (MD)
18 JANE DRIVE
ENGLEWOOD CLIFF, NJ 07632
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2002 |
|
LERNER, ELIZABETH
GLEN RAY ROAD, BOX A
ALDERSON, WV 24910
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/20/2008 |
|
LERNER, JOEL (DPM)
654 BROADWAY
BAYONNE, NJ 07002
NPI-1073540001 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/2023 |
|
LERNER, MARVIN H. (MD)
1321 WASHINGTON STREET
HOBOKEN, NJ 07030
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/5/2002 |
Permanent |
LESLIE, GLENN (DO)
FMC-LEXINGTON, PO BOX 14500
LEXINGTON, KY 40512
NPI-1285712950 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/9/2016 |
|
LESLIE, GLENN (DO)
10 FRANKLIN TURNPIKE
MAHWAH, NJ 07430
NPI-1285712950 |
Medical
Antitrust/Anti-Kickback Acts |
Suspension Human Services
Medical Assistance (Medicaid) |
4/3/2014 |
11/20/2015 |
LESLIE, GLENN (DO)
10 FRANKLIN TURNPIKE
MAHWAH, NJ 07430
NPI-1285712950 |
Medical
Antitrust/Anti-Kickback Acts |
Debarment Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
LETKO, JAMES
USP LEWISBURG P.O. BOX 1000
LEWISHBURG, PA 17837
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/2024 |
|
LETREN, DENISE (CHHA)
916 MADISON AVENUE
UNION , NJ 07083
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/15/2021 |
|
LEVELL, CRYSTAL (LPN)
143 N 12TH STREET
NEWARK, NJ 07107
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2001 |
7/23/2012 |
LEVIN, HARVEY M. (MD)
510 NORTH KINGS HIGHWAY
CHERRY HILL, NJ 08034
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
LEVINE, EDWARD J. (MD)
7 GREEN HILL ROAD
COLTS NECK, NJ 07722
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
6/22/1999 |
7/21/2020 |
LEVIT, NADIA a/k/a NADIA YAKUSHEVA
25 PRIDES LANE
ENGLISHTOWN, NJ 07726
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/8/2024 |
|
LEVY, EDWARD (DDS)
108-34 67TH AVENUE
FOREST HILLS, NY 11375
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/29/2011 |
|
LEVY, RICHARD S. (DPM)
177 MAIN ST. SUITE 235
FORT LEE, NJ 07024
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/20/2001 |
|
LEWANDOWSKI, KENNETH (DO)
100 ATLANTIC AVENUE
CAMDEN, NJ 08101
NPI-1114070398 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/28/2014 |
|
LEWANDOWSKI, KENNETH (DO)
35 TATUM DRIVE
MIDDLETOWN, NJ 07748
NPI-1114070398 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/30/2016 |
|
LEWANDOWSKI, KENNETH (DO)
35 TATUM DRIVE
MIDDLETOWN, NJ 07748
NPI-1114070398 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
LEWIN, TASHEIKA (CHHA)
139 B 14TH AVENUE
ELMWOOD PARK, NJ 07407
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/14/2017 |
8/21/2018 |
LEWIS, ERICA (CHHA)
1098 PENNSYLVANIA AVENUE
FRANKLINVILLE, NJ 08322
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/29/2018 |
|
LEWIS, TOLIA (CHHA)
391 ISABELLA AVENUE
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/19/2017 |
|
LEYBA, ROGELIO
24 WEBSTER STREET
NEWARK, NJ 07104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/11/2016 |
|
LEYKIN, ERIC (owner)
2612 WEST 2ND STREET
BROOKLYN, NY 11223
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/13/2023 |
|
LEYSON, JOSE (MD)
6 RANNEY ROAD
LONG VALLEY, NJ 07853
NPI-1528169539 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/30/2018 |
Permanent |
LEYSON, JOSE (MD)
6 RANNEY ROAD
LONG VALLEY, NJ 07853
NPI-1528169539 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/3/2019 |
|
LI, STAN (MD)
16 SECRETARIO WAY
HAMILTON, NJ 08690
NPI-1386631794 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/18/2015 |
Permanent |
LI, STAN (MD)
16 SECRETARIO WAY
HAMILTON, NJ 08690
NPI-1386631794 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2015 |
Permanent |
LIBRIZZI, MICHELLE H. (LPN)
5 BELLIS CT.
RINGOES, NJ 08551
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/18/2001 |
Permanent |
LICKFIELD, KEVIN J. (DO)
524 JUSTICE DRIVE
MARLTON, NJ 08053
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/3/2003 |
|
LIEBOWITZ, LEONARD J. (MD)
5 POE COURT
MORGANVILLE, NJ 07741
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/18/2001 |
Permanent |
LIEF, BRUCE (MD)
4641 E ROOSEVELT BLVD
PHILADELPHIA, PA 19124
NPI-1134228794 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/20/2019 |
|
LILLO, CHRISTOPHER T. (DMD)
191 HIGHWAY 37 WEST
TOMS RIVER, NJ 08755
NPI-1720150675 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/20/2012 |
|
LIMIDO, GLEN CARL (RPH)
1 EAST PLEASANT AVENUE
MAYWOOD, NJ 07607
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/19/2006 |
|
LIMONGELLI, WILLIAM (DDS)
679 SO ORANGE AVE
NEWARK, NJ 07106
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/30/1986 |
Permanent |
LINDER, NORBERT (MD)
4711 BERGENLINE AVENUE
UNION CITY, NJ 07087
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/23/1977 |
Permanent |
LINDO, PATRICIA A. a/k/a PATRICIA A. LINDO-AHONO (RN)
49 ADAMS STREET
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/12/2026 |
|
LINK, TIMOTHY (MD)
904 SYCAMORE AVENUE
TINTON FALLS, NJ 07724
NPI-1477767705 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/16/2022 |
|
LINK, TIMOTHY (MD)
63 MONMOUTH PARKWAY
MONMOUTH BEACH, NJ 07750
NPI-1477767705 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/5/2018 |
2/23/2022 |
LIPMAN, CLIFFORD R. (MD)
26 UNION AVENUE
FREEHOLD, NJ 07728
NPI-1083676670 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/16/2015 |
5/30/2018 |
LIPPIELLO, JENNIE A. (DC)
2920 RT. 23 SOUTH
NEWFOUNDLAND, NJ 07435
NPI-1366605966 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/19/2001 |
|
LIPSON, PHILIP A. (DO)
38 W. NORTON DRIVE
SOUTHHAMPTON, PA 18966
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/19/2005 |
|
LIRIANO, ANGELA (CHHA)
79 CLINTON AVENUE, APT. #2
JERSEY CITY, NJ 07306
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/22/2017 |
Permanent |
LIRIANO, ANGELA (CHHA)
79 CLINTON AVENUE, APT. #2
JERSEY CITY, NJ 07306
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/14/2017 |
|
LIRIANO, ANGELA (CHHA)
79 CLINTON AVENUE, APT. #2
JERSEY CITY, NJ 07306
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/19/2018 |
|
LIVSHITS, BORIS
1935 83RD STREET, APT E6
BROOKLYN, NY 11214
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/1/2009 |
|
LIZIK, MICHELLE (LPN)
451 FULLERTON AVENUE
CAMBRIDGE SPRINGS, PA 16403
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
LLANOS, LATOYA (CHHA)
433 W. QUINCE STREET
VINELAND, NJ 08360
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/29/2002 |
|
LOAIZA, ERIKA (CHHA)
206 COVENTRY LANE
SOMERSET, NJ 08873
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
LOBO, ANGEL R. (MD)
661 14TH AVENUE
PATERSON, NJ 07504
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/11/2002 |
|
LOBO, ANGEL R. (MD)
398 STEWART AVENUE
GARDEN CITY, NY 11530
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2007 |
|
LOBO, MERCY
22 HELEN PLACE
CLIFTON, NJ 07011
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/23/2007 |
|
LOCK, ABRAHAM J. (MD)
1801 AVENUE J
BROOKLYN, NY 12230
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/25/2001 |
Permanent |
LOCURATOLO, LUIS R. (MD)
104-01 ROOSEVELT AVENUE
CORONA, NY 11368
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/1/1995 |
Permanent |
LOESNER, DIANE (RN)
38 KOVAR STREET
BOGOTA, NJ 07603
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/4/2025 |
|
LOGAN, JEANETTE E. (RN)
12 ARAGON COURT
TRENTON, NJ 08628
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2004 |
|
LOLL-VAN SICKLE, PATRICIA (RN)
416 SALEM STREET
ELMER, NJ 08318
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/20/2000 |
|
LOPEZ, ALFREDO (MD)
10701 E 96TH STREET
INDIANAPOLIS, IN 46256
NPI-1518958040 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2019 |
|
LOPEZ, JOHN J.
428 N 16TH STREET
KENILWORTH, NJ 07033
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/11/2001 |
|
FAMILY DIAGNOSTIC CENTER
293 MONROE STREET
PASSAIC, NJ 07055LOPEZ, JOSE A. (MD)
24 WOODLAND ROAD
BLOOMFIELD, NJ 07003
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/20/2006 |
|
LOPEZ, JULIANA (CHHA)
236 GRAND AVENUE
CAMDEN, NJ 08105
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
LOPEZ-FALCONE, JUAN ANTONIO
8385 SW 43RD STREET
MIAMI, FL 33155
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2003 |
|
LOPRESTI, JACQUELINE A. (DO)
FPC ALDERSON
ALDERSON, WV 24910
NPI-1043348220 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/2014 |
|
LOPRESTI, JACQUELINE A. (DO)
568 RIDGE ROAD
FAIR HAVEN, NJ 07704
NPI-1043348220 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
12/20/2011 |
|
LOTTERMAN, RANDEE (RN)
6 JUNIATA STREET
WEST MILFORD, NJ 07480
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/15/2017 |
|
LOUIS-BAPTISTE, GUERLINE (CHHA)
51 LINCOLN STREET
EAST ORANGE, NJ 07017
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/20/2017 |
|
LOUISSAINT, PARACLET (MD)
669 ELIZABETH AVENUE
NEWARK, NJ 07112
NPI-1164519179 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/1/2001 |
1/11/2017 |
LOUKHNATI, RAJAA (CHHA)
5 COLGATE DRIVE
CHERRY HILL, NJ 08034
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
LOVETT, BETTIE (CHHA)
212 SENACA TRAIL
BROWNS MILLS, NJ 08064
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
5/28/2013 |
|
LOWREY, RODNEY
88 3RD AVE
ATLANTIC HIGH, NJ 07716
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
LU, CHEH S. (DO)
3 DORIS DRIVE WEST
CHERRY HILL, NJ 08003
NPI-1144370057 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2023 |
Permanent |
LU, CHEH SHIUNG (DO)
3 W. DORIS DRIVE #3
CHERRY HILL, NJ 08003
NPI-1144370057 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/18/2024 |
|
LU, KANG (MD)
5753 HIGHWAY 85 N #2442
CRESTVIEW, FL 32536
NPI-1467602953 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/18/2022 |
|
LUCA, BONNIE J.
1016 WASHINGTON GARDEN AP
WASHINGTON, NJ 07882
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
6/10/2007 |
Permanent |
LUCAS, KATINA (RN)
126 LAGUARDIA AVENUE
STATEN ISLAND, NY 10314
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/19/2006 |
|
LUDDEN, JAMES W. (DPM)
23 SOCIETY HILL WAY
TINTON FALLS, NJ 07724
NPI-1720054935 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/19/2016 |
|
LUDDEN, JAMES W. (DPM)
23 SOCIETY HILL WAY
TINTON FALLS, NJ 07724
NPI-1720054935 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/8/2007 |
|
LUDWICK, DONNA (RN)
7 DEER VALLEY LANE, UNIT 12
VERNON, NJ 07462
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/22/2019 |
|
, LUDWIKOWSKI, MICHAEL (RPH)
FCI LORETTO, PO BOX 1000
CRESSON, PA 16630
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/14/2021 |
|
MAIN PHARMACY, LLC.
80 SOUTH MAIN ROAD, SUITE 112
VINELAND, NJ 08360LUDWIKOWSKI, MICHAEL (RPH)
113 DIXONTOWN ROAD
MEDFORD, NJ 08055
NPI-1861705873 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/13/2018 |
|
OLD MEDFORD PHARMACY
639 STOKES ROAD, SUITE 101
MEDFORD, NJ 08055LUDWIKOWSKI, MICHAEL (RPH)
113 DIXONTOWN ROAD
MEDFORD, NJ 08055
NPI-1619148632 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/13/2018 |
|
LUKE, STEPHEN
221 W. JOMAX ROAD
PHOENIX, AZ 85085
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/9/2024 |
|
LUNDY, HOWARD
1 MALKE DRIVE
OCEAN, NJ 07712
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/4/2015 |
|
LUPO, LYNDA a/k/a LYNDA STAMBAUGH-LUPO
32 TOPPINGLIFE DRIVE
BAYVILLE, NJ 08721
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/29/2025 |
|
LUPO, MICHAEL
990 CEDAR BRIDGE AVENUE #121
BRICK, NJ 08723
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/29/2025 |
|
LYNCH, CHRISTOPHER (MD)
1719 PENN CROSSING
ALLENTOWN, PA 18104
NPI-1407813975 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
LYNCH, KATHRYN (LPN)
33 STEVEN TERRACE
SOUTH PLAINFIELD, NJ 07080
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/7/2019 |
|
LYONS, DANA (LPN)
245 4TH AVENUE
ROEBLING, NJ 08554
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/20/2002 |
|
LYONS-VALENTI, ASHLEY (APN/RN)
119 PALMER PLACE
SWEDESBORO, NJ 08085
NPI-1275715179 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/4/2020 |
Permanent |
LYVAN, KIM (DDS)
199 CANAL STREET #201
NEW YORK, NY 10013
NPI-1346458965 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/27/2000 |
|
MAAT, THOMAS P. (LPN)
2311 4TH AVE.
TOMS RIVER, NJ 08753
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/18/2004 |
|
MAATAOUI, BOUCHRA (CHHA)
165 MICHIGAN AVENUE, APT. 1
PATERSON, NJ 07503
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/28/2024 |
|
MABRY, MYRA ANN CUMMINGS (MD)
GLEN RAY ROAD, BOX A
ALDERSON, WV 24910
NPI-1306070719 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2021 |
|
MACAULAY, MATTHEW R. (LSW)
129 EMERSON AVENUE
MIDDLESEX, NJ 08846
NPI-1346706074 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/20/2025 |
|
MACH, PHILIP C. (MD)
PO BOX 1000
LORETTO, PA 15940
NPI-1770562993 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/9/2008 |
|
MACH, PHILIP C. (MD)
30 DANIEL DRIVE
FRANKLIN PARK, NJ 08823
NPI-1770562993 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/7/2008 |
|
MACH, PHILIP C. (MD)
17 SHELDON ROAD
PEMBERTON, NJ 08068
NPI-1770562993 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/30/2018 |
Permanent |
MACIAS, ERICK (DC)
111 E. DEWEY AVENUE, APT. 254
WHARTON, NJ 07885
NPI-1215311329 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/24/2020 |
|
MADDOX, CALISA (CHHA)
42 TRITON TERRACE
NEWARK, NJ 07104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2019 |
|
MADDOX, PEARL V. (CHHA)
KINSLEY ROAD
PEMBERTON, NJ 08068
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/25/2007 |
|
MAES III, EARL B. (MD)
1249 E. MONTCLAIR STREET
SPRINGFIELD, MO 65804
NPI-1699717363 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/18/2025 |
|
MAGGIONCALDA III, EUGENE C. (RN)
15 ABBINGTON LANE
SEWELL, NJ 08080
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/25/2023 |
|
MAGIER, SLAWOMIR (MD)
21 SOUTHFIELD ROAD
EDISON, NJ 08820
NPI-1245220177 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/10/2025 |
|
MAHAJAN, SHYAM S. (MD)
7624-A BRISLIN RD #7
STROUDSBURG, PA 18360
NPI-1144496449 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
MAHARAJ, GANGARAM (RPH)
72 VAN REIPEN AVENUE
JERSEY CITY, NJ 07306
NPI-1326323106 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/22/2017 |
|
MAHER, PATRICIA (RN)
26 PROSPECT STREET
RAMSEY, NJ 07446
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/7/2019 |
|
LA INVALID COACH
1995 JFK BLVD. NO. 14
JERSEY CITY, NJ 07305MAHGOUB, ADAM
1995 JFK BLVD. NO. 14
JERSEY CITY, NJ 07305
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/17/2002 |
|
MAHMOOD, SHAHID
228 GRAND STREET
JERSEY CITY, NJ 07302
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
3/30/2010 |
|
MAHMUD, ASIF (MD)
2024 W. 13TH ST.
BROOKLYN, NY 11223
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/18/2004 |
|
MAIGUE, LLEWELYN (RN)
6 CRYSTAL AVENUE
W. ORANGE, NJ 07052
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/19/2001 |
|
MAIORANO, JOHN (RPH)
123 EAST END AVENUE
ISLAND HEIGHTS, NJ 08732
NPI-1659492940 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
4/18/2002 |
|
MAIO'S MEDICINE CHEST
345 UNION HILL ROAD
ENGLISHTOWN, NJ 07726MAIORANO, JOHN (RPH)
345 UNION HILL ROAD
ENGLISHTOWN, NJ 07726
NPI-1659492940 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/11/2000 |
Permanent |
MAIS, JENNIFER C. (PA)
22 NEW STREET
HILLSDALE, NJ 07642
NPI-1801035084 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/30/2015 |
|
MAKILING, REY (LPN)
202 FLATBUSH AVENUE
EGG HARBOR TOWNSHIP, NJ 08234
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2024 |
|
MAKKER, RAM S. (MD)
52 SNAPDRAGON LANE
ROSLYN HEIGHTS, NY 11577
NPI-1538117213 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/20/2010 |
|
MALADY, SUSAN AKA MAWHINNEY-BRIGNOLA, SUSAN (RN)
PO BOX 468
BLAIRSTOWN, NJ 07825
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2001 |
|
ORIENT EXPRESS
177 SARGEANT AVE.
CLIFTON, NJ 07013MALAMUD, YAFIM
177 SARGEANT AVE.
CLIFTON , NJ 07013
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/8/2003 |
|
MALDONADO, CHEYENNE (PHARM TECH)
3 DUKE DRIVE
TOMS RIVER, NJ 08757
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/5/2017 |
8/30/2023 |
MALDONADO, SANDRA (CHHA)
2808 CONGRESS ROAD
CAMDEN, NJ 08104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/6/2018 |
|
MALDONADO, TOSHIRA (CHHA)
4648 THELMA AVENUE
MAYS LANDING, NJ 08330
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/20/2017 |
8/11/2022 |
MALIK, ATIF #62539-037 (MD)
FCI LORETTO, PO BOX 1000
LORETTO, PA 15940
NPI-1386-63-1869 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/1/2019 |
|
MALIK, MOHAMMAD S.
146 OLD COURT HOUSE RD.
MANHASSETT, NY 11040
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2002 |
|
MALIK, MOHAMMAD S.
146 OLD COURTHOUSE ROAD
MANHASSETT, NY 11400
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
9/22/2000 |
|
MALLOY, TIFFANY (APN/RN)
34 VUBURNUM COURT
LAWRENCEVILLE, NJ 08648
NPI-1790910503 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/28/2017 |
|
MALLOZZI, DEBORAH (RN)
1603 PERSHING AVENUE
FORKED RIVER, NJ 08731
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/28/2017 |
|
MANALO, JERICHO (RN)
22 PINE STREET
BLOOMFIELD, NJ 07109
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/13/2017 |
|
MANCILLA, MARIA (CHHA)
284 REDMOND STREET
NEW BRUNSWICK, NJ 08873
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/14/2007 |
|
MANCINI PHARMACY INC
SKEET & DIXONTOWN ROAD
MEDFORD, NJ 08055MANCINI, ANGELO D. (RPH)
SKEET & DIXONTOWN ROAD
MEDFORD, NJ 08055
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/1/1985 |
Permanent |
MANFORD, ROSE AKA ACQUAH, ROSE (CHHA)
5507 WARNER VIEW LANE
WESTVILLE, OH 43081
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/13/2018 |
|
MANFRE, MARIA (LPN)
262 N. MIDDLESEX COURT
THOROFARE, NJ 08086
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/5/2017 |
|
MANGIONE, MICHELE (RN)
35 LONGVIEW DRIVE
WALDWICK, NJ 07363
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2004 |
Permanent |
MANIN, LAWRENCE
611 BURLINGTON
MT HOLLY, NJ 08060
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/12/1993 |
Permanent |
MANION, WILLIAM (MD)
33 MEADOW ROAD
WOODSTOWN, NJ 08098
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/8/2018 |
|
MANJO, EUNICE AKA GUANMESIA, EUNICE (RN)
128 FIELDBROOK DRIVE
MAGNOLIA, DE 19962
NPI-1811443815 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/3/2019 |
|
MANNAVA, VENKATA SRINIVAS (RPH)
3300 EAST WEST HIGHWAY, APT 206
HYATTSVILLE, MD 20782
NPI-1356478895 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/30/2016 |
|
MANNING, LUTHER
586 WEST SCOTT AVENUE
RAHWAY, NJ 07065
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2008 |
|
MANNO, MICHAEL (DC)
PO BOX 1000 CAMP
FORT DIX, NJ 08640
NPI-1356704738 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2003 |
|
MANSOUR, ALI (MD)
225 DEMOTT LANE
SOMERSET, NJ 08873
NPI-1346225885 |
Medical
Antitrust/Anti-Kickback Acts |
Debarment Human Services
Medical Assistance (Medicaid) |
12/20/2014 |
10/25/2019 |
MANZE, PATRICK (MD)
53 GARDNER AVENUE
CHATHAM, NJ 07928
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/20/2005 |
DECEASED |
MANZELLA, JOHN (DO)
680 BROADWAY AVENUE
PATERSON, NJ 07514
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
6/28/2014 |
|
MANZI, JOHN J. (RPH)
6 TEMPLE ROAD APT 22 C
VINELAND, NJ 08360
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
MANZONI, JANET M. (DC)
52 TENNET ROAD
MORGANVILLE, NJ 07751
NPI-1851497168 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/3/1998 |
|
MANZONI, JANET M. (DC)
9 KILMER DRIVE
MANALAPAN, NJ 07726
NPI-1851497168 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2009 |
|
MARC, DAMILOLA (LPN)
165 FULTON AVENUE, APT. 3
JERSEY CITY, NJ 07305
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/23/2019 |
10/22/2025 |
MARCELL, JOSEPH A.
305 MAIN ST
RIDGEFIELD PARK, NJ 07660
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
MARCHAND, ANTHONY (MD)
19 DEXTER DRIVE NORTH
BASKING RIDGE, NJ 07920
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2003 |
|
MARCHETTA, LEONARD (PA)
FCI-FORT DIX, PO BOX 2000
JOINT BASE MDL, NJ 08640
NPI-1720196140 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/3/2016 |
|
MARCOS, FRANCISCO (RPH)
777 CHARNWOOD DRIVE
WYCKOFF, NJ 07481
NPI-1699158063 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2011 |
4/5/2017 |
MARCUS, ALAN L. (DC)
789 CLIFTON AVENUE
CLIFTON, NJ 07013
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/25/2001 |
Permanent |
MARESSA, JULIAN M. (DO)
1171 CHEW ROAD
WATERFORD WORKS, NJ 08089
NPI-1275643116 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/15/2025 |
Permanent |
MARIS, CHRISTINE aka MYERS, CHRISTINE
408 OHIO AVENUE
PHILLIPSBURG, NJ 08865
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
6/14/2024 |
|
MARKOFF, MORTON (DO)
908 FRANCINE DRIVE
CHERRY HILL, NJ 08003
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/7/1997 |
DECEASED |
MARKOS, MARYAM (CHHA)
95 WINDING WOOD DRIVE, APT. 3B
SAYREVILLE, NJ 08872
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/4/2023 |
|
MARKOSOVA, GRETA (CHHA)
2301 WESTMINSTER BOULEVARD
PARLIN, NJ 08859
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
MARON, ANDREW (DDS)
326 BROAD STREET
RED BANK, NJ 07701
NPI-1215035134 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/21/2015 |
|
MARON, ANDREW (DDS)
326 BROAD STREET
RED BANK, NJ 07701
NPI-1215035134 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/1/2019 |
|
MARONPOT, BARBARA (DDS)
281 MENDHAM ROAD
BERNARDSVILLE, NJ 07924
NPI-1821203696 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/17/2015 |
|
MARQUEZ, MANUEL S. (MD)
112 DOWNING COURT
MT. LAUREL, NJ 08054
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/5/1997 |
DECEASED |
MARQUEZ, OLGA (COUNSELOR)
2827 LINCOLN AVENUE
CAMDEN, NJ 08105
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
4/29/2003 |
|
MARRAZZO-TALLIA, CHRISTAL (RPH)
406 HARDING ROAD
FAIRHAVEN, NJ 07704
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/19/2006 |
|
MARS, INKIE
414 GLEN PARK, APT 404
BRIDGETON, NJ 08302
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/25/2025 |
|
MARSH, TIFFANY
146 CHESTNUT STREET
WEST ORANGE, NJ 07052
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
10/10/2023 |
|
MARSH, TIFFANY
P.O. BOX 27137
FORT WORTH, TX 76127
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/20/2023 |
|
MARSON-FRANCIS, JAVON (CHHA)
7810 CORBETT ROAD
PENNSAUKEN, NJ 08109
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/18/2017 |
|
MARTIN, ANDRE (COUNSELOR)
127 N. DERBY AVENUE
VENTNOR, NJ 08406
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
5/24/1999 |
Permanent |
MARTIN, BENNIE M. (COUNSELOR)
476 CLIFTON AVENUE
CLIFTON, NJ 07011
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
5/15/2003 |
|
MARTIN, CHERYL LEE a.k.a. JOHNSTON, CHERYL ANDERSON (RN)
600 PACIFIC AVENUE, APT B203
ATLANTIC CITY, NJ 08401
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/18/2021 |
|
MARTIN, ELLIOTT (DPM)
5 HOLLIS ROAD
E. BRUNSWICK, NJ 08816
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/22/1991 |
DECEASED |
MARTIN, MARGARET
207 HEGGEN AVENUE
EGG HARBOR TOWNSHIP, NJ 08234
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2024 |
|
MARTIN, MARGARET (LPN)
207 HEGGEN AVENUE
EGG HARBOR TOWNSHIP, NJ 08234
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/8/2017 |
Permanent |
MARTIN, PATRICK
51 HENRY STREET
SUCCASUNNA, NJ 07876
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
MARTIN, SUSAN C. (RN/LPN)
3421 BRIGHTON STREET
PHILADELPHIA, PA 19149
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2005 |
|
MARTINEZ, CINTYA (CHHA)
61 CONCORD STREET, APT. 3A
JERSEY CITY, NJ 07306
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
MARTINEZ, ELIEZER (COUNSELOR)
215 SOUTH BURLINGTON ROAD
BRIDGETON, NJ 08302
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/20/2006 |
|
MARTINEZ, MELISSA (CHHA)
211A LOIS LANE, APT. A
LAKEWOOD, NJ 08701
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2023 |
|
MARTINEZ, NATASHA (CHHA)
87 N. 7TH STREET, APT. 1
PATERSON, NJ 07522
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/26/2018 |
|
MARTINEZ, RENATO F. (MD)
199 BROAD ST., SUITE 1-A
BLOOMFIELD, NJ 07003
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/5/1997 |
|
MARTINIQUE, BURTON (OD)
2 SHEFFIELD DRIVE
WILLINGBORO, NJ 08046
NPI-1942370945 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/18/2016 |
|
MARTINIZEZ, SUZETTE (CHHA)
52 FOREST GLEN DRIVE
HIGHLAND PARK, NJ 08904
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/31/2017 |
|
MARTINO, ROCCO (MD)
111 KNICKERBOCKER ROAD
CLOSTER, NJ 07624
NPI-1558331728 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/15/2025 |
Permanent |
MARTIROSOV, ALEKSANDR (DO)
1084 BRIAR WAY
FORT LEE, NJ 07024
NPI-1700931185 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2017 |
5/30/2018 |
MARTORANO, JOSEPH (RPH)
1248 STANWOOD STREET
PHILADELPHIA, PA 19100
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
MARTUCCI, JOELLE (LPN)
23 COOLIDGE AVENUE
TOTOWA, NJ 07512
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/11/2025 |
|
MARUCCI, DONATO (MD)
14 FRANKLIN STREET
BELLEVILLE, NJ 07109
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/28/1999 |
Permanent |
MARURI, NAGESWARA REDDY (RPH)
8 REDWOOD AVENUE
WEST ORANGE, NJ 07052
NPI-1083932495 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/1/2016 |
|
MASCOLO, JOSEPHINE (RN)
1814 KENNEDY BLVD.
UNION CITY, NJ 07087
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/7/2004 |
|
MASHALI, FATHALLA #86065-038 (MD)
FMC DEVENS, PO BOX 879
AYER, MA 01432
NPI-1386609907 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2018 |
|
MASI, JAMES (COUNSELOR)
631 OCEAN AVENUE, APT.304
BRADLEY BEACH, NJ 07720
NPI-1518046226 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/20/2013 |
|
MASON, JAMES I.
702 SUNSHINE LAKES DRIVE
VOORHEES, NJ 08043
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
2/23/2000 |
|
MASON, SYDELLE
702 SUNSHINE LAKES DRIVE
VOORHEES, NJ 08043
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
2/23/2000 |
|
MASOOD, MARUK
1 CHESTERFIELD DRIVE
WARREN, NJ 07059
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2012 |
|
MASOOD, YOUSUF (MD)
PO BOX 8000
BRADFORD, PA 16701
NPI-1235343138 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2012 |
|
MASOUD, MARIAM (CHHA)
194 CORNELISON AVE, APT 200
KEARNY, NJ 07032
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/17/2023 |
|
MASRI, NASSER M.
360 GETTY AVENUE
PATERSON, NJ 07503
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/19/2000 |
2/15/2019 |
MASSARO, DONNA M. (THERAPIST)
205 RIVA DRIVE APT 24
HACKETTSTOWN, NJ 07840
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/20/2008 |
|
MASTRANGELO, MARTHA (LPN)
12 NORTH 28TH AVENUE
LONGPORT, NJ 08403
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
MASTRIA, ERNEST (PSYCH)
213 9TH AVE
BELMAR, NJ 07719
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/18/2011 |
|
MASTROKOSTAS, ANTHANASIOS (RPH)
11 EQUINOX LANE
FREEHOLD, NJ 07728
NPI-1861769481 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/15/2009 |
2/15/2019 |
MATALON, VIVIENNE (MD)
1 NORTH SYRACUSE DRIVE
CHERRY HILL, NJ 08034
NPI-1396858635 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/19/2016 |
|
MATALON, VIVIENNE (MD)
1 NORTH SYRACUSE DRIVE
CHERRY HILL, NJ 08034
NPI-1396858635 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/31/2016 |
|
MATHEW, REX (MD)
131 WEST PARKWAY
POMPTON PLAINS, NJ 07444
NPI-1336164862 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/2/2017 |
|
MATHEW, REX (MD)
17608 PRINCE EDWARD DRIVE
OLNEY, MD 20832
NPI-1336164862 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/4/2018 |
|
MATRISS, JOSEPH P. (DDS)
337 HENRY STREET
HASBROUCK HEIGHTS, NJ 07604
NPI-1700013554 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
10/9/2007 |
|
MATRISS, JOSEPH, P. (DDS)
337 HENRY STREET
HASBROUCK HEIGHTS, NJ 07604
NPI-1700013554 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
9/18/2003 |
|
MATTERN, JILL (MD)
20 WILSON TERRACE, APT 1
STATEN ISLAND, NY 10304
NPI-1669514253 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/29/2015 |
|
MATTHEWS, BHA'SHEER (CHHA)
16 HEMLOCK WALK
CAMDEN, NJ 08104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/18/2017 |
|
MATURA, DENISE (RN)
1001 LINDEN AVENUE
BRICK, NJ 08723
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
10/26/1999 |
7/20/2012 |
MATURA, WILLIAM (DC)
PO BOX 7000
FORT DIX, NJ 08640
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/20/2006 |
|
MATZ, RODNEY S. (MD)
43 MACDONALD DRIVE
WAYNE, NJ 07470
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/1995 |
Permanent |
MAUGLE, BARBARA (DPM)
800 HILLSIDE AVENUE
WESTFIELD, NJ 08901
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/10/2001 |
Permanent |
MAUIRI, SANDY (LPN)
34 FRANKLIN PL.
TOTOWA, NJ 07512
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2005 |
|
MAWHINNEY-BRIGNOLA, SUSAN AKA MALADY, SUSAN (RN)
PO BOX 468
BLAIRSTOWN, NJ 07825
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2001 |
|
MAXIMOUS, HEBA (CHHA)
274 MONTICELLO AVENUE
JERSEY CITY, NJ 07306
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/17/2023 |
|
MAXIMOUS, MARSA (CHHA)
110 BALDWIN AVENUE, APT 5
JERSEY CITY, NJ 07306
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/17/2023 |
|
MAXVITAT, KATHLEEN E. (PHARM TECH)
200 W. MERCHANTS STREET
AUDUBON, NJ 08106
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/20/2011 |
|
INDEPENDENCE MEDICAL TRANS.
3 PARKWOOD DRIVE
SOUTH AMBOY, NJ 08879MAXYMIV, NICOLAI
3 PARKWOOD DRIVE
SOUTH AMBOY, NJ 08879
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/10/2003 |
|
MAYER, FREDRICK G. (DC)
610 WOODLAND AVENUE
AVON BY THE SEA, NJ 07717
NPI-1811082894 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2000 |
9/21/2011 |
MAYS, CYNTRICE (CHHA)
98 OAK STREET
CLEMENTON, NJ 08021
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/19/2017 |
|
MAYS, ROBERT E.
6133 HANLON STREET
CAPITAL HEIGHTS, MD 20743
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/31/2017 |
|
MAZOUZ, SANAA (CHHA)
10 N COAL STREET
SHAMOKIN, PA 17872
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2023 |
|
MAZUR, BONNIE (DMD)
210 E. SEAVIEW AVENUE
LINWOO, NJ 08221
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/27/1998 |
|
MAZZA, ANTHONY aka KARLEWICZ, ERIC
353 S. PASCACK ROAD
SPRING VALLEY, NY 10977
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/11/2024 |
|
MCAFEE, JORDAN (CHHA)
13 FAIRWAY COURT
MARLTON, NJ 08053
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2017 |
|
MCAULAY-LEVESQUE, BARBARA (LPN)
141 BRUNSWICK AVENUE
BLOOMSBURY, NJ 08804
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/27/2019 |
Permanent |
MCCABE, LAUREN AKA BARSH, LAUREN (RN)
9 FIELDCREST WAY
HAZLET, NJ 07730
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/30/2019 |
|
MCCABE, VALERIE A. (LPN)
830 CHESTNUT STREET
KEARNY, NJ 07032
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2004 |
Permanent |
MCCAFFERTY, ASHLEY (RN)
245 ATLANTIC AVENUE, APT. 115
LONG BRANCH, NJ 07740
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/29/2019 |
|
MCCAGG, CAROLINE (MD)
1415 MARTINE AVENUE
PLAINFIELD, NJ 07060
NPI-1346261849 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/18/2019 |
Permanent |
MCCALL, ELDORA (CHHA)
OLD CRANBURY ROAD
CRANBURY, NJ 08512
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2007 |
|
MCCANN, DAVID
16 LAFAYETTE PLACE
LYNDHURST, NJ 07071
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/3/2019 |
|
MCCARVILLE, MICHAEL (MD)
1020 IRVING AVENUE
ENDICOTT, NY 13760
NPI-1871666321 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
MCCASKILL, CAMMY
6518 BOBOLINK PLACE
PHILADELPHIA, PA 19142
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
MCCASKILL, JACQUELINE (CHHA)
34 36 12TH AVENUE
PATERSON, NJ 07524
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/15/2004 |
|
MCCOLGAN, PETER (DMD)
RR 1, PO BOX 29
TANNERSVILLE, PA 18372
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/19/2001 |
|
MCCOLGAN, PETER (DMD)
35 OLD WOLFE ROAD
BUDD LAKE, NJ 07828
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/13/1999 |
Permanent |
MCCREA, NIOME (CHHA)
63 VILLAGE DRIVE
BARNEGAT, NJ 08005
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/26/2017 |
|
MCDANIELS, HOLLY (RN)
111 COUNTRYSIDE DRIVE
MYRTLE BEACH, SC 29579
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/28/2017 |
|
MCDONALD, JOSEPH (MD)
2052 MORRIS AVENUE
UNION, NJ 07083
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/21/1999 |
Permanent |
MCDONALD, KEITH (THERAPIST)
2220 MEADOW LANE, APT.D26
SECAUCUS, NJ 07094
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2001 |
Permanent |
McDONALD, LISA (RN)
23 PEBBLE LANE
LEVITTOWN, PA 19054
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/9/2025 |
|
MCDONALD, RHONDA (RN)
962 GROVE STREET
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/18/2007 |
|
MCDONALD-HASWELL, EVERSLEY
52 ELM STREET
MONTCLAIR, NJ 07042
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/18/2002 |
|
MCDOWELL, SHASHAWN (CHHA)
25 WILLIAM STREET, 2ND FLOOR
LITTLE FALLS, NJ 07424
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/6/2017 |
|
MCELROY, DONALD J. (DDS)
14 RESEVOIR AVENUE
DOVER, NJ 07801
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/1983 |
Permanent |
McFADDEN, PATRICK (MD)
740 S COLUMBUS BLVD, UNIT 10
PHILADELPHIA, PA 19147
NPI-1083027916 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/22/2024 |
|
MCFADDEN, TIKEYA (CHHA)
526 RAND STREET
CAMDEN, NJ 08105
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
McFARLANE, KERI JANE a.k.a. BENTLEY, KERI McFARLANE (MD)
10616 EAGLES VIEW DRIVE
KNOXVILLE, TN 37922
NPI-1588688998 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/19/2024 |
|
MCGAVIN, CAMERON LINDSAY (PSYCH)
417 BOYD STREET
TURTLE CREEK, PA 15145
NPI-1760408041 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/27/2015 |
|
MCGEE, ELIZABETH (RN)
51 VAN DUYNE AVE
WAYNE, NJ 07470
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/20/2002 |
|
MCGEE, JOHN (MD)
1160 KENNEDY BOULEVARD
BAYONNE, NJ 07002
NPI-1811991284 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/6/2016 |
|
MCGILL, WINSTON (MD)
258 CENTRAL AVENUE
ORANGE, NJ 07050
NPI-1093810749 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/16/2014 |
|
MCGINNIS, GEORGE J.
119 ADELINE ST
TRENTON, NJ 08611
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/16/1986 |
Permanent |
MCGINTY, JAMIE (RN)
251 DEVON ROAD
TWP. OF WASHINGTON, NJ 07676
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/22/2017 |
|
MCGLONE, CARL (RN)
10 MILLS BROOK LANE
SHAMONG, NJ 08088
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/11/2019 |
|
MCGLOSTER, CARL L. (DDS)
90 TIFFANY BOULEVARD
NEWARK, NJ 07104
NPI-1962517839 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2007 |
|
MCGRATH, HELEN J. (RN)
6 BLAIR RD.
KEDALL PARK, NJ 08824
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2005 |
|
MCGRATH, ROBERT (DO)
3411 KENWOOD COURT
MAYS LANDING, NJ 08330
NPI-1912110636 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/13/2020 |
Permanent |
MCGRATH, ROBERT (DC)
FORT DIX FCI, PO BOX 2000
JOINT BASE MDL, NJ 08640
NPI-1417989864 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2018 |
|
MCGRATH, ROBERT (DO) #70889-050
CANAAN USP, PO BOX 300
WAYMART, PA 17837
NPI-1912110636 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/5/2019 |
|
McHUGH, JANE E. (RN)
172 ORIENT STREET, APT 2
BAYONNE, NJ 07002
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/12/2022 |
|
MCINTYRE, JOHN G. (DDS)
1301 PENN AVENUE
WYOMISSING, PA 19610
NPI-1487740718 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/22/2002 |
12/2/2011 |
MCKEAN JR., JOSEPH (MD)
2601 MEADOW VIEW ROAD
EDMOND, OK 73013
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/15/2000 |
Permanent |
MCKEITHAN, SHAVONNE (LPN)
259 SECOND STREET
HACKENSACK, NJ 07601
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/5/2017 |
|
MCKNIGHT, BOBBY
4543 NORTH GRATZ STREET
PHILADELPHIA, PA 19140
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
MCLAUGHLIN, KELLY M. (LPN)
SANDYBROOK ROAD
MANALAPAN, NJ 07726
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2008 |
|
MCLAY, WILLIAM (MD)
1150 GEORGIA AVENUE
CAPE MAY CH, NJ 08210
NPI-1033133970/1659585438 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/16/2018 |
Permanent |
MCLEAN, EDWARD
506 MONTICELLO COURT
MARLTON, NJ 08053
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/18/2002 |
|
MCLEISH, FREDERICK (RPH)
5 WINDSOR DRIVE
EGG HARBOR TOWNSHIP, NJ 08234
NPI-1447461504 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2017 |
Permanent |
MCLEOD, MEGHAN AKA WHITE, MEGHAN (CHHA)
271 SERPENTINE DRIVE
BAYVILLE, NJ 08721
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/8/2019 |
|
MCMAHON, THOMAS (MD)
121 WARWICK ROAD
HADDONFIELD, NJ 08033
NPI-1952309742 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/15/2016 |
Permanent |
McMILLION, VIRGIL WAID (DO)
232 SANTORINI AVENUE
MORGANTOWN, WV 26508
NPI-1073520466 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/15/2022 |
11/16/2023 |
MCMURTRY-BURRELL, DIANE (RPH)
MDC BROOKLYN, PO BOX 329002
BROOKLYN, NY 11232
NPI-1609015015 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2015 |
|
MCMURTRY-BURRELL, DIANE (RPH)
MDC BROOKLYN, PO BOX 329002
BROOKLYN, NY 11232
NPI-1609015015 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
MCPHERSON, KIMBERLY (CHHA)
110 THOMAS AVENUE
LAWNSIDE, NJ 08045
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
6/16/2022 |
MCPHERSON, LEEANNE (RPH)
269 HAMPTON STREET
BRIDGETON, NJ 08302
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/7/2008 |
|
MCQUEEN, BRITTANY (CHHA)
807 N. INDIANA AVENUE
ATLANTIC CITY, NJ 08401
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/23/2018 |
|
MCRAE, CHANEL (CNA)
448 RAILROAD BLVD.
RICHLAND, NJ 08350
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/23/2006 |
|
MEDVEDIK, YELENA
2 HICKORY HILLS COURT
HOLMDEL, NJ 07733
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/3/2013 |
|
MEDVEDOVSKY, ANDREW (MD)
11 AUTUMN DRIVE
MOORESTOWN, NJ 08057
NPI-1649431594 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/4/2020 |
|
MEEHAN, KATHLEEN AKA MEEHAN-KIERMIER, KATHLEEN (DMD)
1116 BENNETT DRIVE
WOODBURY, NJ 08096
NPI-1245445931 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/26/2018 |
4/9/2019 |
MEGARIOTIS, EVANGELOS (MD)
21 RAVONA STREET
CLIFTON, NJ 07012
NPI-1336144583 |
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/19/2024 |
Permanent |
MEHTA, LALIT (MD)
11 AZALEA TRL
WESTFIELD, NJ 07090
NPI-1578526349 / 1417266982 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/31/2026 |
Permanent |
MEHTA, MAHESH (MD)
157 RUTGERS PLACE
NUTLEY, NJ 07110
NPI-1396859385 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/2/2020 |
|
MEISHER, VLAD A. (PSYCH)
HILLSIDE TERR.
FAIR LAWN, NJ 07410
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/10/2007 |
Permanent |
MEISHER, VLAD A. (PSYCH)
15-07-PLAZA ROAD APT. A
FAIRLAWN, NJ 07410
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/1/2009 |
|
MEJIA, NATIVIDAD (CHHA)
1425 PALM STREET
READING, PA 19604
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/26/2025 |
|
MELENDEZ, JUANITA (COUNSELOR)
NORTH 35TH STREET
CAMDEN, NJ 08105
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
4/29/2003 |
|
MELENDEZ, LIZZADY (CHHA)
602 SOUTH 4TH STREET
CAMDEN, NJ 08103
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/26/2018 |
|
MELKER, NEIL L. (DMD)
219 VALLEY ROAD
PRINCETON, NJ 08540
NPI-1053443705 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/23/2009 |
|
MELTZER, SCOTT M. (DMD)
70 WELLESLEY WAY
FREEHOLD, NJ 07728
NPI-1366561425 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/17/2014 |
5/21/2020 |
MELTZER, SCOTT M. (DMD)
70 WELLESLEY WAY
FREEHOLD, NJ 07728
NPI-1366561425 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/3/2013 |
5/21/2020 |
MEMBER, BERNARD J. (MD)
12335 S. ANNA DRIVE
ROCKVILLE, MD 23146
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2004 |
|
MEMON, KAREEM
8557 NW 47TH STREET
CORAL SPRINGS, FL 33067
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/8/2024 |
|
MENDEL, RICHARD
701 SOUTH HOWARD AVENUE, SUITE 106
TAMPA, FL 33606
NPI-1306939202 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2015 |
|
MENDEZ, EDELFONSO (DO)
SMITH AVENUE
NORTH BERGEN, NJ 07047
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/2008 |
|
MENDEZ, NORMA (CHHA)
60 BALDWIN STREET, #2
NEW BRUNSWICK, NJ 08901
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
MENKIN, SERGE
670 N. BEERS STREET
HOLMDEL, NJ 07733
NPI-1881670785 / 1205121316 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/4/2024 |
3/2/2026 |
MENSAH, ENOCK
532 WINDSOR COMMON BLDG 5
EAST WINDSOR, NJ 08512
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
10/10/2023 |
|
MENSAH-NARH, STEVEN (RPH)
WEDGEWOOD DRIVE
NORTHBRUNSWICK, NJ 08902
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2007 |
|
MEO, JOHN
149 BOWNE ROAD
WAYSIDE, NJ 07712
NPI-1427086818 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/27/2009 |
2/12/2025 |
MERLINO, WILLIAM (MD)
4630 SOMERS POINT ROAD
MAYS LANDING, NJ 08330
NPI-1992802557 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/16/2023 |
|
MERLINO, WILLIAM (MD)
4360 SOMERS POINT ROAD
MAYS LANDING, NJ 08330
NPI-1992802557 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2023 |
|
MERVIL, DARLENE (CHHA)
122 ROSSITER AVENUE
PATERSON, NJ 07502
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/31/2018 |
|
MESA, NELSON (PCA)
964 GROVE STREET, APT. A
ELIZABETH, NJ 07202
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/17/2017 |
|
MESSICK, PAULA (LPN)
105 SUMMIT AVENUE
EWING, NJ 08628
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/18/2009 |
|
MESSO, RALPH #67159-050 (MD)
FCI FORT DIX, PO BOX 2000
JOINT BASE MDL, NJ 08940
NPI-1184798621/1255309175 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/26/2018 |
|
MESSO, RALPH (MD)
2 RICHMONDE COURT
COLTS NECK, NJ 07722
NPI-1184798621/1255309175 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/28/2015 |
|
METTEAUX, IYANNAH (CHHA)
46 N. ARLINGTON AVENUE
EAST ORANGE, NJ 07017
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
METZ, DANIEL
FCI OTISVILLE #66799-050
OTISVILLE, NY 10963
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2015 |
2/16/2022 |
MEYER, CYNTHIA (RN)
8200 KENNEDY BOULEVARD
NORTH BERGEN, NJ 07047
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2018 |
|
MEYER, GLORIA
KINGS HIGHWAY
MIDDLETOWN, NJ 07748
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
MEYER, JOSEPH
KINGS HIGHWAY
MIDDLETOWN, NJ 07748
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
MEYERLE, GISELA (RN)
705 SUNFLOWER AVENUE
LANGHORNE , PA 19047
NPI-1356538169 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/28/2018 |
|
MEYERLE, GISELA (RN)
705 SUNFLOWER AVENUE
LANGHORNE , PA 19047
NPI-1356538169 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/25/2019 |
|
MEZERENEZ, MARIA (CHHA)
33 ASPEN PLACE
PASSAIC, NJ 07055
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/6/2018 |
|
MGBEME, FESTUS (RPH)
882 BROAD STREET
NEWARK, NJ 07114
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/8/2001 |
Permanent |
MICHAIL, MEDHAT (DDS)
848 BERGEN AVENUE
JERSEY CITY, NJ 07306
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/29/1998 |
|
MICHEL, RONY (RN)
FCI FORT DIX, P.O. BOX 2000
JOINT BASE MDL, NJ 08640
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2024 |
|
MICHIEKA, DOREEN (CHHA)
13 PRIMROSE LANE
BRICK TOWNSHIP, NJ 08724
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/18/2024 |
|
MIGLIETTA, MAURIZIO A. (DO)
309 NEWARK AVENUE
POINT PLEASANT BEACH, NJ 08742
NPI-1710973243 / 1255451745 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/9/2026 |
|
MIKHAIL, PETER (RPH)
48 FALLON AVE.
ELMONT, NY 11003
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/18/2004 |
Permanent |
MIKOS, KRISTEN (RN)
211 PRINCETON AVENUE
PHILADELPHIA, PA 19149
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2017 |
|
MIKSIS, MARY E. (RN)
126 WINSTEAD DRIVE
WESTAMPTON, NJ 08060
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/17/2004 |
|
MIL, PAUL
USP LEWISBURG #65099-050, PO BOX 1000
LEWISBURG, PA 17837
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/9/2017 |
|
MILLER, DEBBIE (DO)
94 EAST WATER ST
TOMS RIVER, NJ 08753
NPI-1750561866 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/26/2002 |
DECEASED |
MILLER, DEIDRE
20 PERENNIAL LANE
WILLINGBORO, NJ 08046
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2001 |
Permanent |
MILLER, DEIDRE, T.
92 RITTENHOUSE DRIVE
WILLINGBORO, NJ 08046
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/29/2000 |
Permanent |
MILLER, JOSEPH M. (DO)
9 VICTORIA CIRCLE
JACKSON, NJ 08527
NPI-1255307856 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2015 |
|
MILLER, JUSTIN (PSYCH)
616 DALE COURT WEST
RIVERVALE, NJ 07675
NPI-1952594921 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/2/2017 |
Permanent |
MILLER, RANDALL (DO)
1015 VAN HOUTEN AVE
CLIFTON, NJ 07013
NPI-1740342575 |
Medical
Wage & Hour Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/1/2001 |
4/6/2017 |
MILLER, ROY C.
703 WEST SHORE TRAIL
LAKE MOHAWK, NJ 07871
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
MILLER, SANDRENE (MD)
50 UNION AVE., SUITE 401
IRVINGTON, NJ 07111
NPI-1912192527 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/25/1998 |
|
MILLER, SANDRENE A. (MD)
202 ELMWYND DRIVE
ORANGE, NJ 07050
NPI-1912192527 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/22/1999 |
|
MILLET, CYNTHIA (CHHA)
104 ROUTE 46 EAST
ELMWOOD PARK, NJ 07407
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/24/2017 |
|
MILMAN, BORIS
655 AMBOY AVENUE
WOODBRIDGE, NJ 07095
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/11/2001 |
Permanent |
MILORADOVICH, VADIM (MD)
58 MERCER AVENUE
HARTSDALE, NY 10530
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2013 |
|
MILVIHILL, CHELSIE (CHHA)
501 MAPLE STREET
LAKEHURST, NJ 08733
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/18/2017 |
|
MIMS, CAROLE
1058 WILLOW STREET
NORRISTOWN, PA 19401
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
MINATEE, SHERAI (LPN)
509 WARWICK ROAD
LAWNSIDE, NJ 08045
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/15/2018 |
|
MINNOW, MARY (CHHA)
9 WINDINGWOOD DRIVE
SAYERVILLE, NJ 08872
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/25/2001 |
Permanent |
MIRAGLIA, ROBERT (LCSW)
254 VOSE AVENUE
SOUTH ORANGE, NJ 07079
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/9/2002 |
|
MIRANDA, MEREDITH (RPH)
3204 BLUE MOUNTAIN LANE
NAZARETH, PA 18064
NPI-1053740993 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/25/2016 |
|
MIRILASHVILI, MOSHE B. (MD)
PO BOX 350146
BROOKLYN, NY 11235
NPI-1427081223 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/17/1999 |
Permanent |
MIRZA, MUHAMMAD A. (MD)
11 ROOSEVELT AVENUE
FANWOOD, NJ 07023
NPI-1841227121 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/13/2021 |
|
MIRZA, MUHAMMED (MD)
145 GARRISON AVENUE
JERSEY CITY, NJ 07306
NPI-1467450262 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/8/2019 |
11/18/2019 |
MISHRA ARUNA (MD)
63 WEST BROADWAY
SALEM, NJ 08079
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/4/1997 |
Permanent |
MISHRA, ARUNA (MD)
217B AUBURN ROAD
PILESGROVE, NJ 08098
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/3/2000 |
Permanent |
MISTRY, BHAVESH (PT)
76 GARDEN COURT
SAINT AUGUSTINE, FL 32092
NPI-1588788376 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/15/2022 |
|
MITRA, RANJIT (PSYCH)
2366 ST. GEORGES AVENUE
RAHWAY, NJ 07065
NPI-1417096942 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/12/2014 |
|
MITRA, RANJIT (PSYCH)
300 WOODBINE COURT APT1T
RIDGEWOOD, NJ 07450
NPI-1417096942 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2015 |
|
MITRESKI, IGOR (MD)
10 IVY LANE
WALLINGTON, NJ 07057
NPI-1629305255 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/26/2015 |
|
MITSUI, MASAO (MD)
9 BRIARWOOD ROAD
JERSEY CITY, NJ 07305
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/20/2001 |
|
MITTAL, NIRANJAN (MD)
7404 5TH AVENUE, FLOOR 2
BROOKLYN, NY 11209
NPI-1083680003 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/25/2024 |
|
MIXI, NATACHA JEAN LOUIS (CHHA)
2119 ALDRIN ROAD APT 4B
OCEAN, NJ 07712
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/14/2022 |
|
MOCKOVIAK, PATRICIA (LPN)
5 BEECH STREET
EDISON, NJ 08817
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/19/2004 |
|
MODICA, JOSEPH (CHHA)
82 JEFFERSON STREET
SOUTH BOUND BROOK, NJ 08880
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
MOHAMED, ASHLI (CHHA)
10-4 FOUNTAIN AVENUE
TRENTON, NJ 08618
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
MOHAMED, ASHLI (CHHA)
10-4 FOUNTAIN AVENUE
TRENTON, NJ 08618
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
11/6/2018 |
|
A & H MEDICAL TRANSPORT.
PO BOX 8332
JERSEY CITY, NJ 07308MOHAMED, HASHIM H.
P. O. BOX 8332
JERSEY CITY, NJ 07308
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/12/1994 |
Permanent |
MOHAMMAD, AKIKUR REZA (MD)
7018 ELMSBURY LANE
WEST HILLS, CA 91307
NPI-1306956271 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2023 |
|
MOHAMMAD, OMAR (RPH)
15 GRISTMILL LANE
UPPER SADDLE RI, NJ 07458
NPI-1053580068 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2012 |
5/17/2018 |
MOHAMMAD, OMAR (RPH)
15 GRIST MILL LANE
UPPER SADDLE RI, NJ 07458
NPI-1053580068 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/20/2012 |
5/17/2018 |
MOHAPELOA, GUGU (MD)
6 CORNELL ROAD
PARLIN, NJ 08859
NPI-1306952635 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/3/2019 |
Permanent |
MOJICA, MARIA (CHHA)
108 BEECH STREET
PATERSON, NJ 07501
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
MOLDAVER, INNA
32 BEACHWOOD AVENUE
EDISON, NJ 08837
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/17/2016 |
|
MOLINA, DANIEL (RPH)
320 EAST 42ND STREET, APT. 618
NEW YORK, NY 10017
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/28/2017 |
|
MONACO, STEVEN
21 JAMIE DRIVE
SEWELL, NJ 08080
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/19/2022 |
|
MONDELO, BARBARA AKA DOMINICO, MARIA AKA BARBARA TAYLOR J.
KENTWOOD BLVD
BRICK, NJ 08724
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
10/24/2008 |
|
MONFORTO, CHRISTINE (RN)
2620 HAMILTON DRIVE
VOORHEES, NJ 08043
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2015 |
3/24/2026 |
MONICA, JULIANNE H. (DC)
509 ESSEX AVENUE
SPRING LAKE, NJ 07762
NPI-1235372608 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/20/2002 |
|
MONK, SHENISE (LPN)
416 CHAMBERS AVENUE
CAMDEN, NJ 08103
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/24/2018 |
|
MONSUL, ROBERT W. (MD)
301 NORTH MAIN STREET
MANVILLE, NJ 08835
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/10/1990 |
Permanent |
MONTE, LYDA (MD)
430 W. BROWNING ROAD, APT. M2
BELLMAWR, NJ 08031
NPI-1114068236 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/4/2018 |
Permanent |
MONTE, LYDA (MD)
430 W. BROWNING ROAD, APT. M2
BELLMAWR, NJ 08031
NPI-1114068236 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/3/2019 |
|
MONTES, NANCY (CHHA)
17-20 WELL DRIVE
FAIR LAWN, NJ 07410
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/1/2017 |
|
MONTORIO, JENNIFER (CHHA)
110 OUTER DRIVE
DINGMANS FERRY, PA 18328
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/11/2019 |
|
MOON, RASHIKA (RN)
2 JASON CIRCLE
PENNS GROVE, NJ 08069
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/28/2017 |
|
MOONEY, MARY MELISSA (LPN)
777 CHERRY TREE ROAD
ASTON, PA 19014
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/23/2007 |
|
MOOR, JEAN (RN)
100 COLONIAL WAY
ALIQUIPPA, PA 15001
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
MOORE, BRITTANY (CHHA)
141 BORDEN AVENUE
ASBURY PARK, NJ 07712
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/14/2017 |
|
MOORE, HANEEFAH (CHHA)
48 MONTROSE TERRACE
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/3/2018 |
|
MOORE, JANE A. (RN)
235 KINGS ROAD
MADISON, NJ 07940
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/19/2005 |
|
MOORE, JONATHAN R. (MD)
19 N. PEARL STREET
BRIDGETON, NJ 08302
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/19/1997 |
Permanent |
MOORE, LILLIE R.
353 S. CENTER ST., APT 19
ORANGE, NJ 07050
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2002 |
|
MOORE, LYNDA A. (LPN)
10719 JUREL CT. W. APT B
LAKEVILLE, MN 55044
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/19/2005 |
|
MOORE, MONICA AKA OZERY, TZIPORA
27 FIRETOWER ROAD
BUDD LAKE, NJ 07828
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/15/2017 |
|
MOORJANI, KAMAL (RPH)
217 VAN BUREN STREET
LYNDHURST, NJ 07071
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/2010 |
|
MOORMANN, BARBARA ANN (CHHA)
2467 BREATHSTONE DRIVE
POWELL, OH 46065
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
MORALES SR., OSVALDO
78 W. 180TH STREET
BRONX, NY 10453
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/16/2011 |
|
MORALES SR., OSVALDO
78 W. 180TH STREET 2ND FL
BRONX, NY 10453
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/13/2008 |
|
MORALES, ARLENE
254 NORTH 7TH STREET
NEWARK, NJ 07107
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2002 |
|
MORALES, CHRISTINO
PO BOX 26883
PHILADELPHIA, PA 19134
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
7/2/2003 |
|
MORALES, CHRISTINO
328 MARKET STREET
CAMDEN, NJ 08102
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/5/2000 |
|
MORALES, FERNANDO (CNA)
346 S. MAIN STREET
PHILLIPSBURG, NJ 08865
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/21/2004 |
|
MORALES, JAMES (MD)
2319 CRYSTAL MILE COURT
TOMS RIVER, NJ 08755
NPI-1386649507/1013940006 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/11/2016 |
4/11/2016 |
MORALES, JAMES (MD)
16 WOODVIEW DRIVE
HOWELL, NJ 07731
NPI-1386649507/1013940006 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/11/2016 |
|
MORALES, JAMES (MD)
16 WOODVIEW DRIVE
HOWELL, NJ 07731
NPI-1386649507/1013940006 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/30/2017 |
|
MORALES, JUSTINA (CHHA)
62 HIGH STREET
WOODBURY, NJ 08096
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
MORALES, SOLANGE (CHHA)
871 RADIO ROAD
LITTLE EGG HARBOR TOWNSHIP, NJ 08087
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2023 |
|
MORALES, VANISHA JAZMIN (CHHA)
73 MADISON STREET, FL 1
PATERSON, NJ 07501
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/27/2025 |
|
MOREL, MARIA (CHHA)
735 TWENTY SECOND STREET
PATERSON, NJ 07504
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/14/2017 |
|
MORELAND, CHARLOTTE (CHHA)
121 A PROSPECT VILLAGE
TRENTON, NJ 08618
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/29/2008 |
|
MORELAND, CHARLOTTE (CHHA)
121 PROPECT VILLAGE, APTA
TRENTON, NJ 08618
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2008 |
|
MORELLI, TIMOTHY J. (RPH)
801 BUTLER PIKE
MERCER, PA 16137
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/19/2005 |
|
MORELOS, LISA A. (RN)
162 SHENANDOAH BLVD.
TOMS RIVER, NJ 08753
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/19/2003 |
|
MORENO, BARTOLO (COUNSELOR)
2221 38TH STREET
PENNSAUKEN, NJ 08110
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
4/29/2003 |
|
MORERA, JESSICA (CHHA)
116 DALTON STREET
ROSELLE PARK, NJ 07204
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
MORGANSTEIN, HENRY (DO)
774 CARTERET COURT
MT. LAUREL, NJ 08054
NPI-1689730343 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/23/2010 |
|
MORGANSTEIN, HIRAM N. (OD)
5618 BERGENLINE AVENUE
WEST NEW YORK, NY 07093
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/22/2001 |
Permanent |
MORIARTY, JACK
312 GRANDE RIVER BLVD.
TOMS RIVER, NJ 08755
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/8/1999 |
Permanent |
MORRIS, CANDICE (CHHA)
154 NORTH SPRING STREET, UNIT B
BLOOMFIELD, NJ 07003
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/22/2018 |
Permanent |
MORRIS, CHRISTINE (CHHA)
323 KAIGHN AVENUE
CAMDEN, NJ 08103
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/16/2018 |
|
MORRISON, JAMES C. (MD)
RADIO RD AT EAST BOAT
TUCKERTON, NJ 07087
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
MORTON, MARION (RPH)
2321 SPRUILL AVE, APT 917
NORTH CHARLESTON, SC 29405
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
2/6/2012 |
|
MOSHKOVITCH, VASIL (MD)
41 NAUTILUS DRIVE
MANAHAWKIN, NJ 08050
NPI-1326116419 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/22/2016 |
Permanent |
MOSHKOVITCH, VASIL (MD)
41 NAUTILUS DRIVE
MANAHAWKIN, NJ 08050
NPI-1326116419 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/3/2017 |
Permanent |
MOSKOWITZ, MYRON (DPM)
705 RIDGE DRIVE
UNION, NJ 07083
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/20/2006 |
|
MOSS, ALBERT H. (MD)
28 BARTLE ROAD
SOMERSET, NJ 08873
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/19/2005 |
|
MOSS, ROBERT H. (DPM)
244 N. MAIN STREET
MULLICA HILL, NJ 08062
NPI-1881716348 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/2/2011 |
|
MOSS, ROBERT H. (DPM)
244 NORTH MAIN STREET
MULLICA HILL, NJ 08062
NPI-1881716348 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2013 |
|
MOSS, ROBERT H. (DPM)
244 NORTH MAIN STREET
MULLICA HILL, NJ 08062
NPI-1881716348 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
MOSSAVI, AHMAD (MD)
7 MALKE DRIVE
OCEAN, NJ 07712
NPI-1629046248 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/23/2012 |
|
MOTA, KAESHA (CHHA)
433 N. 7TH STREET
CAMDEN, NJ 08102
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/14/2017 |
|
MOTT, TARA (RN)
3557 SHARON ROAD
WEST MIDDLESEX, PA 16159
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
MOULDER, DARIA (PHARM TECH)
2715 BAYSHORE ROAD
VILLAS, NJ 08251
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/20/2010 |
|
MOURACHOV, PAVEL
3917 WEST ROAD, SUITE 137
LOS ALAMOS, NM 87544
NPI-1083711121 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2015 |
|
MOZULAY, MARK J. (MD)
512 TOWNSHIP LANE
BLUE BELL, PA 19422
NPI-1669631719 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
|
MUHAMMAD, ABDUL B. (MD)
284 BROADWAY
NEWARK, NJ 07104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/8/2004 |
Permanent |
MUHAMMAD, DIAMONNIQUE (CHHA)
354 7TH AVENUE WEST
NEWARK, NJ 07107
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/14/2017 |
|
MUID, JANNAH
671 LINCOLN AVE
ORANGE, NJ 07050
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/18/2010 |
5/25/2023 |
MUISE, NICOLLETE (CHHA)
172 FRANKLIN ROAD
DENVILLE, NJ 07834
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/8/2017 |
|
MUKHTAR, JUNAID
114 BALDWIN AVENUE
JERSEY CITY, NJ 07306
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
6/5/1997 |
|
MULLANGI, KUMAR R. (MD)
SOUTH BROADWAY STREET
BURLINGTON, IA 52601
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2008 |
|
MULLIGAN, RACHEL M.
241 HAWAII DRIVE
BRICK, NJ 08723
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/11/2008 |
|
MULTANI, GURMEET (PSYCH)
1055 CALLE DE LAS PALM
REDLANDS, CA 92373
NPI-1528225406 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/9/2011 |
|
MUNGEN, JONETTA V. (CHHA)
34 VERMONT AVENUE
NEWARK, NJ 07106
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2001 |
|
MUNN, DONIELLE (CHHA)
150 HOME AVENUE, FL. 2
TRENTON, NJ 08611
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
MUNOZ BALBUENA, YUDY (CHHA)
220 NEW YORK AVENUE
BERGENFIELD, NJ 07621
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/5/2023 |
|
MUNOZ, GUILLERMO (DO)
395 SPRING STREET
UNION, NJ 07083
NPI-1023071669 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/25/2015 |
5/13/2016 |
MUNOZ, JULIO ANTHONY
4 NORMAL AVENUE
UPPER MONTCLAIR, NJ 07043
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/26/2006 |
|
MUNRO, FAWN LEA a/k/a FAWN LEA ORBAN (RN)
115 GLENRIDGE STREET
ALPENA, MI 49707
NPI-1174803233 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/20/2024 |
|
MUNSIF, ANAND (MD)
127 E. NORTHFIELD ROAD
LIVINGSTON, NJ 07039
NPI-1982879805 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/7/2011 |
|
MUNZEL, GREGORY THOMAS
140 WAPPOO CREEK DRIVE
CHARLESTON, SC 29412
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
4/22/2012 |
|
MURRAY, LAKIRAH (LPN)
1311 NE 77TH AVENUE
GAINESVILLE, FL 32609
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/5/2018 |
12/19/2023 |
THE EXCEL CENTER, INC.
104 WINDSOR COURT
PALM BEACH, FL 33480MURRY JR., TOMMIE
2697 RAVEN ROAD
CINNAMINSON, NJ 08077
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
5/25/1999 |
Permanent |
THE EXCEL CENTER, INC.
104 WINDSOR COURT
PALM BEACH, FL 33480MURRY JR., TOMMIE
2697 RAVEN ROAD
CINNAMINSON, NJ 08077
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/5/2001 |
Permanent |
THE EXCEL CENTER, INC.
104 WINDSOR COURT
PALM BEACH, FL 33480MURRY JR., TOMMIE
2697 RAVEN ROAD
CINNAMINSON, NJ 08077
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/20/2002 |
|
MUSCARRA, GERALD C. (DMD)
525 WASHINGTON AVENUE
HOBOKEN, NJ 07030
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
MUSCIO, ROBERT (MD)
333 BROAD STREET
RED BANK, NJ 07701
NPI-1578510723 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/19/2015 |
6/15/2023 |
MYERS, CHRISTINE
408 OHIO AVENUE
PHILLIPSBURG, NJ 08865
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/20/2024 |
|
MYERS, CHRISTINE aka MARIS, CHRISTINE
408 OHIO AVENUE
PHILLIPSBURG, NJ 08865
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/14/2024 |
|
MYERS, HOWARD (MD)
103 FAIRWAY TERRACE
DOWNS, NJ 08054
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
MYNDIUK, JAROSLAW (MD)
96 TUXEDO PARKWAY
NEWARK, NJ 07106
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/27/1988 |
DECEASED |
NAEEM, MOHSIN A. (RPH)
FCI BUTNER MEDIUM I P.O. BOX 1000
BUTNER, NC 27509
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/19/2023 |
|
NAGLE, BRITTANY (RN)
709 NORTH VICTORIA AVENUE
VENTNOR CITY, NJ 08406
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/25/2016 |
|
NAIMOLI, DANIELLE
824 HOLIDAY COURT
TOMS RIVER, NJ
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/30/2005 |
|
NAKHLA, FEBE (CHHA)
100 GLENWOOD AVE.
JERSEY CITY, NJ 07306
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/31/2023 |
|
NALBONE, PHILLIP C. (RN)
24 RUNNING BROOK ROAD
TRENTON, NJ 08638
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/17/2004 |
|
NANDI, ANINDITA (MD)
127 HIGHLAND AVENUE
JERSEY CITY, NJ 07306
NPI-1669563995 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/12/2018 |
|
NAPENAS, VICTOR
14 SPRUCE LANE
PISCATAWAY, NJ 08854
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2012 |
|
NAPENAS, VICTOR T.
14 SPRUCE LANE
PISCATAWAY, NJ 08854
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/17/2011 |
|
NARAYAN, PRITHVI (MD)
33 COOPER AVENUE, UNIT 213
LONG BRANCH, NJ 07740
NPI-1982699823 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/25/2021 |
Permanent |
NARDACHONE, JASON S.
15 RIVER ROAD, APT J
NUTLEY, NJ 07110
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2024 |
|
NARO, MARYANN (LPN)
23 DOWNING ROAD
HAMILTON, NJ 08690
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/25/2019 |
|
NASH, JENNIFER (RN/APN)
621 ASTER LANE
RIVERVALE, NJ 07675
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/3/2016 |
|
NASR, WAFDIA (CHHA)
11990 BEACH BLVD., APT. 44
JACKSONVILLE, FL 32246
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/5/2023 |
|
NASSAR, MANAR (CHHA)
229 ACADEMY STREET
JERSEY CITY, NJ 07306
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/31/2023 |
|
NASSERY, MOHAMMAD (MD)
59 TREELINE DRIVE
MARSTON MILLS, MA 02648
NPI-1992763510 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/9/2016 |
|
NATALE, JOSEPH
216 NORTH AVENUE E STE2
CRANFORD, NJ 07016
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
1/24/2014 |
|
NATHAN, MICHAEL (MD)
1 PROSPECT LANE
OKATIE, SC 29909
NPI-1578593422 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/1/2017 |
|
NATOVICH, BORIS
996 PINE TERRACE
FRANKLIN LAKES, NJ 07417
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
9/18/2003 |
|
NATOVICH, LEV
996 PINE TERRACE
FRANKLIN LAKES, NJ 07417
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
9/18/2003 |
|
MKM NURSING HOME SPEC.INC
1368 BRENTWOOD ROAD
YARDLEY, PA 19067NAVAZIO, DAVID
1368 BRENTWOOD ROAD
YARDLEY, PA 19067
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/7/2000 |
1/5/2018 |
NAYLOR, KIM M. (PHARM TECH)
1504 TAMIAMI ROAD
FORKED ROAD, NJ 08731
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
9/19/2011 |
|
NAZARIO, JULISSA (CHHA)
210 ROSEVILLE AVENUE, APT. C-1
NEWARK, NJ 07107
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
NDUBIZU, FLORENCE
5 MILTON COURT
PRINCETON JCTN, NJ 08550
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
10/29/2024 |
|
NDUBIZU, GORDIAN A.
5 MILTON COURT
PRINCETON JCTN, NJ 08550
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/10/2024 |
|
NEAL, LAYONA (CHHA)
545 E. TOILE COURT
BURLINGTON, NJ 08016
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/13/2018 |
|
NEALS, SHERRY (CHHA)
63 DALES AVE, APT. 1124
JERSEY CITY, NJ 07306
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2001 |
|
NEGRI, MARY J (DC/RN)
514 LAFAYETTE ROAD SUITE F
SPARTA, NJ 07871
NPI-1063594836 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2015 |
|
NEGRON, JOANNA (CHHA)
1343 LANDSDOWNE AVENUE
CAMDEN, NJ 08104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2017 |
|
NELSON, SIDNEY (MD)
4517 BERGENLINE AVENUE
UNION CITY, NJ 07087
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/13/1999 |
Permanent |
NESSMAN, LAWRENCE (DO)
143 GREENRALE AVENUE
WAYNE, NJ 07470
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/24/1997 |
Permanent |
NEUMAN, JOSEF
144 SHADY LANE DRIVE
LAKEWOOD, NJ 08701
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/22/2023 |
|
NEWBY, YVONNE (CHHA)
38 WINANS STREET, APT. 3
EAST ORANGE, NJ 07018
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/29/2017 |
|
NEWMAN, ALEXANDER (PHD)
372 N. WOODLAND STREET
ENGLEWOOD, NJ 07631
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/10/1999 |
Permanent |
NEWMAN, JACLYN (RN)
133 BUTTERCUP COURT
WHITEHOUSE STATION, NJ 08889
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/26/2025 |
|
NEWMAN, MICHAEL J. (DMD)
192 GABRIEL TERRACE
SOUTH AMBOY, NJ 08879
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/18/2001 |
Permanent |
NEWMARK, MALINDA (RN)
38 STONY HILL ROAD,APT101
MONROE TOWNSHIP, NJ 08831
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/19/2005 |
|
NEWMARK, THOMAS (MD)
225 CHAPEL AVENUE
CHERRY HILL, NJ 08002
NPI-1740380997 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/19/2016 |
Permanent |
NEWMARK, THOMAS (MD)
4700 CITY AVENUE, APT. 11307
PHILADELPHIA, PA 19131
NPI-1740380997 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/17/2017 |
Permanent |
NEWSOME, DORITA (DDS)
163 CHAPEL STREET
ORANGE, NJ 07050
NPI-1306063235 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/23/2009 |
|
NEWTON, ANDREW (PSYCH)
129 EAST 5TH STREET
MOUNT CARAMEL, PA 17851
NPI-1154349330 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
5/17/2022 |
NEYMET, ALLA (CHHA)
127 GARDEN TERRACE
EDISON, NJ 08817
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/29/2018 |
|
NGOAJIA, MARK
403 WILLOW POINT DRIVE
JACKSON, NJ 08527
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/16/2015 |
|
NGUYEN, TONY (MD)
10294 GREENSPIRE DRIVE
OAKTON, VA 22124
NPI-1083872675 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/28/2017 |
|
NIAZ, ASIM
P.O. BOX 420
FAIRTON, NJ 08320
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
8/19/2010 |
|
NICHOLS, LEE
505 HARDING ROAD
RED BANK, NJ 07704
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/22/2023 |
|
NICHOLSON, BEVERLY (CNA)
139 HOLLYWOOD AVENUE
EAST ORANGE, NJ 07108
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/13/2006 |
|
NICKELS, JOHN HARVEY aka NICKELS, JOHN HARVEY II aka NICKELS, JOHN HARVEY III (MD)
165 BURIWCK ROAD
CLEVELAND, OH 44143
NPI-1629181490 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2020 |
|
NICOLL, DAVID G.
312 BOULEVARD
MOUNTAIN LAKES, NJ 07046
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/21/2015 |
7/4/2019 |
NICOLL, DAVID G. #65321-050
USP CANAAN, PO BOX 300
WAYMART, PA 18472
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/4/2019 |
|
NICOLL, SCOTT R.
120 BUNKER HILL ROAD
WAYNE, NJ 07470
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/21/2015 |
|
NICOSIA, BETTY LOU
204 CIRCLE DRIVE
STEUBEN, OH 43953
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2015 |
|
NIELSON, STEVEN C. (DPM)
845 DAWN AVENUE
EPHRATA, PA 17522
NPI-1538595772 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/23/2009 |
|
NIETO, NICOLE (RN)
11 WATTS AVENUE
BARNEGAT, NJ 08005
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/11/2023 |
|
NIGALAN, MANUEL (MD)
8 MIMI COURT
NORTHFIELD, NJ 08225
NPI-1497809909 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/14/2010 |
|
NII, ROBERT (PA)
34 MILL BROOK ROAD
PISCATAWAY, NJ 08854
NPI-1124254107 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/21/2016 |
Permanent |
NIKPARVAR-FARD, MEHDI a/ka/ MEHDI NIKPARVARFARD a/ka/ MEHDI ARMANI
PHILADELPHIA FDC, P.O. BOX 562
PHILADELPHIA, PA 19105
NPI-1699761353 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/2024 |
|
NINOS, DIANE E.
569 E. 33RD STREET
PATERSON, NJ 07613
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/28/2001 |
Permanent |
NISBETT, MELVIN (CHHA)
205 LA CASCATA
CLEMENTON, NJ 08021
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
NISIVOCCIA, CHARLES (DC)
260 MAIN STREET
LITTLE FALLS, NJ 07424
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2006 |
|
NISLER, JANIS (RN)
127 WEST WOODBRIDGE AVENUE
ISELIN, NJ 08830
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/24/2019 |
11/22/2022 |
NOBLES, MARITZA (CHHA)
34 CENTER OAK AVENUE
LAWNSIDE, NJ 08045
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
NOBORE, ABIEYUWA (CHHA)
776 SOUTH 13TH STREET
NEWARK, NJ 07108
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
NOEL, EDWARD (LPN)
469 E. 93RD STREET, APT. 6
BROOKLYN, NY 11212
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/25/2019 |
10/21/2025 |
NOLASCO, THERESA (RN)
19 BANTA ROAD
KINNELON, NJ 07405
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/14/2022 |
|
NOMULA, SUNITHA (RN)
107 HAMMELL PLACE, APT. 107
MAYWOOD, NJ 07607
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/22/2024 |
|
NONCENT, JENNIFER (CHHA)
949 CARTERET AVENUE
UNION, NJ 07083
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
NONZIATO, CHARLES G. (DO)
247 CENTER STREET
TRENTON, NJ 08611
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/13/1991 |
DECEASED |
NOOR, FARID A. (MD)
5 GITHERS LANE
MEDFORD , NJ 08055
NPI-1770751513 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
4/12/2004 |
|
NOOR, FARID A. (MD)
596 ANDERSON AVENUE
CLIFFSIDE PARK, NJ 07010
NPI-1770751513 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/30/2015 |
|
NOOR, FARID A. (MD)
350 A DELANCEY PLACE
MOUNT LAUREL, NJ 08054
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/19/2008 |
|
NORDMAN, CRAIG J.
4 ERNA PLACE
WHIPPANY, NJ 07981
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/21/2015 |
|
NORDMAN, CRAIG J.
FCI SCHUYLKILL, PO BOX 759
MINERSVILLE, PA 17954
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/18/2019 |
|
NOWINSKI, VANESSA AKA AMATO, VANESSA A. (RN)
65 LOCUST AVENUE
N. ARLINGTON, NJ 07031
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2003 |
|
NSIAH, KENNETH (CHHA)
827 S. 17TH STREET, 2ND FLOOR
NEWARK, NJ 07108
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/14/2017 |
|
NTSHONA, NOKUZOLA S. (MD)
113-15 34TH AVE, #4B
CORONA, NY 11368
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/12/2000 |
Permanent |
NURIK, BARUCH
APT 9C PARKVIEW & MADISON
LAWRENCE HARBOR, NJ 08879
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/30/1995 |
Permanent |
NUSSBAUM, ABRAHAM (MD)
91 MONTGOMERY STREET
RHINEBECK, NY 12572
NPI-1578598082 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/15/2001 |
11/12/2013 |
NUTT, TRACY (RN)
27 OVERLOOK DRIVE
MOUNT LAUREL, NJ 08054
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/11/2019 |
|
NWANKWO, FESTUS (RPH)
154 BLOOMFIELD AVENUE
NEWARK, NJ 07104
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/18/1998 |
Permanent |
NWANKWO, FESTUS (RPH)
306 ARDSDALE TERRACE
UNION, NJ 07083
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/18/1999 |
Permanent |
PARK AVENUE PHARMACY
278 PARK AVENUE
NEWARK, NJ 07107NWANKWO, RAPHAEL
278 PARK AVENUE
NEWARK, NJ 07107
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/19/1999 |
Permanent |
NWANOSIKE, CHINYERE (CHHA)
1301 BRIARWOOD DRIVE
WILLIAMSTOWN, NJ 08094
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/28/2024 |
2/26/2026 |
OBADUN, FUNMI MODUPE a/k/a AWELEWA, FUNMI M.
80 TELFORD STREET
NEWARK, NJ 07106
NPI-1811399397 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2024 |
|
OBEROI, MANDEEP S. (MD)
341 MCKINLEY AVENUE
EDISON, NJ 08820
NPI-1922158542 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/12/2025 |
|
O'CALLAGHAN, TERESE (RN)
5122
ORCHARD WAY, NJ 08109
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2002 |
|
OCANSEY, DONNA (RN)
7 WISINA COURT
MEDFORD, NJ 08055
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
4/22/2012 |
7/19/2019 |
OCCEAN, NERLANDE (CHHA)
811 DILL AVENUE
LINDEN, NJ 07036
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
OCHOA, MARTHA IVETTE (CHHA)
1717 MYRTLE AVENUE
PLAINFIELD, NJ 07063
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/31/2023 |
|
O'CONNELL, MARK (MD)
18 CENTER STREET, REAR
RUMSON, NJ 07760
NPI-1669514253 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/9/2015 |
|
ODOMS, TIFFANY E.
926 TILGHMAN STREET
CHESTER, PA 19013
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/18/2008 |
|
O'DONNELL, KATHERINE
141 MAIN STREET
METUCHEN, NJ 08840
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/30/2005 |
|
O'DONNELL, LISA (RN)
845 BROADWAY
BAYONNE, NJ 07002
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/15/2018 |
|
O'DONNELL, WILLIAM (DC)
7 NINEBARK LANE
OXFORD, NJ 07863
NPI-1659601177 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/28/2019 |
|
ODUNZEH, UCHE
3565 LAUREL FORTE MEADE RD., APT. 41
LAUREL, MD 20724
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
ODUSUSI, ABIMBOLA (CHHA)
311 GOLDSMITH AVENUE
NEWARK, NJ 07112
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/31/2023 |
|
OFFOR, CHINWE (MD)
15 CHABLIS DRIVE
DIX HILLS, NY 11746
NPI-1508811019 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/12/2019 |
|
OFFOR, CHINWE (MD)
15 CHABLIS DRIVE
DIX HILLS, NY 11746
NPI-1508811019 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/11/2019 |
|
OGANDO, ERNESTINA (CHHA)
943 SHERIDAN AVENUE
ELIZABETH, NJ 07208
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/18/2017 |
6/28/2018 |
OGBEIDE-SIMMS, RACHEL (CHHA)
15 MAPES PLACE, APT. 2
NEWARK, NJ 07112
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
OGON, BERNARD (MD)
520 PRATT PL
LINDEN , NJ 07036
NPI-1255509873 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
1/6/2022 |
|
OGORODOVA, GANNA (CHHA)
310 BROMLEY PLACE
EAST BRUNSWICK, NJ 08816
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
OGUNBOWALE, OLAITAN ADEKUNBI (CHHA)
238 MOUNT PLEASANT AVENUE, APT. 3
NEWARK, NJ 07104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2023 |
|
OGUNTUASE, EBENEZER (PSYCH)
10 DOCKSIDE DRIVE
EGG HARBOR, NJ 08234
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/20/2009 |
|
OGUNYEMI, TENIOLA OLUWAKEMI (LPN)
14 LOWELL STREET
ISELIN, NJ 08830
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/18/2024 |
|
O'HERN, DANIEL (MD)
18 FLEETWOOD DRIVE
GOSHEN, NY 10924
NPI-1144369554 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/3/2017 |
Permanent |
OJIKYTU, SIMBIAT T. (CHHA)
51 LEXINGTON BLVD
BARNEGAT, NJ 08005
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2014 |
|
OJO, RICHARD O.
346 FIELDCREST AVENUE
NEW EGYPT, NJ 08533
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/24/2009 |
|
OKANTAH, MARGARET (CHHA)
1854B MANOR DRIVE
UNION, NJ 07083
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/30/2005 |
|
HEALTHCORE PHARMACY
289 GEORGE STREET
NEW BRUNSWICK, NJ 08901OKOYE, GOODWIN S. (RPH)
289 GEORGE STREET
NEW BRUNSWICK, NJ 08901
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
1/12/2001 |
4/9/2025 |
HEALTHCORE PHARMACY
289 GEORGE STREET
NEW BRUNSWICK, NJ 08901OKOYE, PATRICK C. (RPH)
289 GEORGE STREET
NEW BRUNSWICK, NJ 08901
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
1/12/2001 |
Permanent |
OKPALOR, JANE C. (RN)
24 MCGUIRE STREET
METUCHEN, NJ 08840
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/17/2024 |
|
OKREM, JANINE (RN)
1112 HARKER AVENUE
WEST DEPTFORD, NJ 08096
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/12/2018 |
10/4/2023 |
OLADUNJOYE, ZINAB (CHHA)
254 MAGNOLIA AVENUE
SMYRNA, DE 19977
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2023 |
|
OLIVEIRA JR., MARIO (OD)
170 EAST KINNEY STREET
NEWARK, NJ 07105
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/28/2005 |
|
OLIVER, ANDREA AKA SCHLEMBACH, ANDREA (APN/RN)
70 COHANSEY STREET
BRIDGETON, NJ 08302
NPI-1780630418 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/12/2016 |
5/21/2020 |
OLIVER, HOWARD WALLACE
P.O. BOX 600, HOUSING UNIT DJH1056
CHINO, CA 91708
NPI-1518911742 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2022 |
|
OLIVER, JAMES (DDS)
167 MAIN STREET
METUCHEN, NJ 08840
NPI-1134314594 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/13/1999 |
Permanent |
OLIVERA, PABLO R. (DPM)
2 CEDAR STREET
NEWARK, NJ 07102
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2001 |
|
OLIVERA, SMIRNA (LPN)
33 REMSEN AVENUE
NEW BRUNSWICK, NJ 08901
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2002 |
|
OLIVEROS, APRIL (LPN)
233 SMOKERISE LANE
TOMS RIVER, NJ 08755
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/5/2017 |
|
OLIYNYK, OKSANA (CHHA)
591 MARLBORO ROAD
OLD BRIDGE, NJ 08857
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
OLUWA, WURAOLA (CHHA)
241 S. 7TH STREET
NEWARK, NJ 07103
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2023 |
|
OLUWOLE, OLAKUNLE K. (MD)
379 OLD TAPPAN ROAD
OLD TAPPAN, NJ 07675
NPI-1932177144 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/20/2023 |
|
MUGAHID MEDICAL SHUTTLE
1116 ANNE STREET
ELIZABETH, NJ 07201OMAR, HATIEM AKA HATIM
1116 ANNE STREET
ELIZABETH, NJ 07201
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/10/1999 |
Permanent |
EMPIRE STATE MEDICAL SVCS
144 ELMORE AVENUE, SUITE 204
ELIZABETH, NJ 07201OMAR, MUGAHID
7-11 TONNELE AVENUE
JERSEY CITY, NJ 07306
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/14/1998 |
Permanent |
OMAR, MUGAHID O.
7-11 TONNELLE AVE-2MN
JERSEY CITY, NJ 07306
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/10/1997 |
Permanent |
ONAFOWAKAN, OLAYINKA (CHHA)
96 TRACEY AVENUE
NEWARK, NJ 07108
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2023 |
|
O'NEILL - RYAN, LISA ANNE (COUSELOR)
415 LYNDALE STREET
PHILLIPSBURG, NJ 08865
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/9/2008 |
|
O'NEILL-RYAN, LISA ANN (COUNSELOR)
415 LYNDALE STREET
PHILLIPSBURG, NJ 08865
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/17/2008 |
|
ONYEKAHA, EBERE (RPH)
13 HIGHLAND AVENUE
MAPLEWOOD, NJ 07040
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
ONYENSO, CHIKEZIE (MD)
552 MAIN STREET
CHATHAM, NJ 07928
NPI-1578605812 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
2/15/2012 |
5/6/2021 |
ONYENSO, CHIKEZIE (MD)
18 EDINBURGH DRIVE
RANDOLPH, NJ 07869
NPI-1578605812 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/19/2015 |
5/6/2021 |
OPOKU, BISMARK (CHHA)
2468 ANGLER ROAD
COLUMBUS, OH 43224
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/6/2018 |
|
OPPONG-DWAMENA, SETH
15 UNIVERSITY PLACE
EAST BRUNSWICK, NJ 08816
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/10/2020 |
Permanent |
OQUENDO, BASHIRAH (CHHA)
87 MANNING AVENUE
PLAINFIELD, NJ 07060
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
O'REILLY, MARGARET (RN)
38 REILEY MOUNTAIN ROAD
CUDDEBACKVILLE, NY 12729
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/25/2019 |
|
O'REILLY, RAYMOND B.
188 ALEXANDRIA DR APTS
HACKETTSTOWN, NJ 07840
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
OREM, SUSAN (RN)
140 VALERIE DRIVE #488
MANVILLE, NJ 08835
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2006 |
|
ORIA, CONRAD (RN)
525 BLOOMFIELD AVENUE
CALDWELL, NJ 07006
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/5/2017 |
8/22/2024 |
ORQUIZA III, CLODUALDO S (MD)
2103 ZION ROAD
NORTHFIELD, NJ 08225
NPI-1326040155 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/1/2021 |
|
ORT II, CHARLES C. (PA)
P.O. BOX 481
HACKETTSTOWN, NJ 07840
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/18/2004 |
Permanent |
ORTEGA, ANA (CHHA)
14 PALM STREET
MONMOUTH JUNCTION, NJ 08852
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
ORTEGA, VICTOR
GUAYNBO- PO BOX 2147
SAN JUAN, PR 00922
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/18/2002 |
|
ORTELL, CARL (RPH)
221 TINDERBOX LANE
MARLTON, NJ 08053
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/5/1983 |
Permanent |
ORTILLO, ASHLEY (RN)
1261 MALAGA ROAD
MAYS LANDING, NJ 08330
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/11/2025 |
|
OSAIGBOVO, ASHLEY (CHHA)
130 PAMPHYLIA AVENUE, APT. #70
BRIDGETON, NJ 08302
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/19/2017 |
|
OSA-OMORUYI, ENANIGHO (CHHA)
25 OSBORNE TERRANCE # 1
NEWARK, NJ 07108
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2023 |
|
OSAWE, ADREMI (CHHA)
739 S 12TH STREET, APT. 1
NEWARK, NJ 07103
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2023 |
|
OSEI, CALVIN (RPH)
2 SYSLO COURT
SAYREVILLE, NJ 08872
NPI-1497931794 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/4/2012 |
6/12/2018 |
OSEI, FRANCIS (LPN)
50 N. EVERGREEN ROAD, APT. 170M
EDISON, NJ 08837
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/24/2017 |
8/13/2024 |
OSEI, PASCAL
9 SOUTH GROSSER PLACE
SOMERSET, NJ 08873
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
7/17/2009 |
7/17/2014 |
OSEI-AKOTO, JOYCE (LPN)
18 HIGHLAND AVENUE
MAPLEWOOD, NJ 07040
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/5/2025 |
|
OSHADIPE, ADERINSOLA (CHHA)
28103 CANYON WREN DRIVE
KATY, TX 77494
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2023 |
2/4/2025 |
OSIFO, BAHEEJAH (CHHA)
530 PARK AVENUE
ORANGE, NJ 07050
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
OSMANOFF, GARY (DDS)
NETTER COURT
MARLBORO, NJ 07746
NPI-1710188073 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/23/2008 |
8/23/2024 |
OSMANOFF, GARY (DDS)
317 MARINE AVENUE
BROOKLYN, NY 11209
NPI-1710188073 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
12/17/2008 |
8/23/2024 |
OSTERGAARD, PAUL (MD)
230 WEST PARKWAY
POMPTON PLAINS, NJ 07444
NPI-1962504753 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/16/2015 |
|
OSTERGAARD, PAUL (MD)
230 WEST PARKWAY
POMPTON PLAINS, NJ 07444
NPI-1962504753 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/21/2014 |
|
OSTERGAARD, PAUL (MD)
15 MOUNTAIN AVENUE
POMPTON PLAINS, NJ 07444
NPI-1962504753 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/11/2016 |
|
OSTROSKIE, JOAN (LPN)
424 FLORENCE STREET
NEW MILFORD, NJ 07646
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/19/2003 |
|
OSTWALD, ALICE (LPN)
11 RAILROAD LANE
WHITEHORSE , NJ 08889
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2006 |
|
OSUJI, PAUL
FCI FORT DIX PO BOX 2000
FORT DIX, NJ 08640
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2009 |
|
OSWARI, DANIEL
35 ALLEGHANY LANE
BORDENTOWN, NJ 08505
NPI-1265506489 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2024 |
|
OSWARI, DANIEL (MD)
35 ALLEGHENY LANE
BORDENTOWN, NJ 08505
NPI-1265506489 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/30/2020 |
|
OTI, CHUCK B.
676 PARK AVE., BLDG. 14B
EAST ORANGE, NJ 07017
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2000 |
Permanent |
OTOO, LOVE (CHHA)
555 ELIZABETH AVENUE
NEWARK, NJ 07112
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
OTTENSTEIN, ALAN (MD)
3100 PRINCETON PIKE
LAWRENCEVILLE, NJ 08648
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/1/2009 |
|
OTTENSTEIN, ALAN (MD)
173 MOUNT EYRE RD.
WASHINGTON CROS, PA 18977
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/19/2005 |
|
OWUSU, NICHOLAS (CHHA)
6063 HAMPSTEAD DRIVE W
COLUMBUS , OH 43229
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/27/2017 |
Permanent |
OWUSU-ANSAH, GRACE (CHHA)
97-22 57TH AVENUE
CORONA, NY 11368
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/17/2018 |
|
OWUSUWAA, REGINA (CHHA)
1508 WESTMINSTER BLVD
PARLIN, NJ 08859
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/4/2025 |
|
OXMAN, REED S. (MD)
226 W. RITTENHOUSE SQUARE
PHILADELPHIA, PA 19103
NPI-1649575473 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/16/2012 |
|
OYEFESO, ABIDEMI (CHHA)
357 S 8TH STREET
NEWARK, NJ 07102
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2023 |
|
OYELEKE, AMINAT (CHHA)
8600 S COURSE DRIVE
HOUSTON, TX 77099
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2023 |
|
OYENUSI, ADEBOWALE (RPH)
90 WASHINGTON STREET
EAST ORANGE, NJ 07017
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
10/14/2000 |
Permanent |
OZERY, TZIPORA AKA MOORE, MONICA
27 FIRETOWER ROAD
BUDD LAKE, NJ 07828
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/15/2017 |
|
PABBATHI, RAMMOHAN
3 AMY COURT
HOWELL, NJ 07731
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/8/2005 |
|
GLV PARKE WARNER PHCY
481 EDWARD H ROSS DRIVE
ELMWOOD PARK, NJ 07407PACHECO, ALVARO R.
59 EDGEHILL COURT
WEST ORANGE, NJ 07052
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
PACHECO, MICHAEL (PHARM TECH)
84 LAFAYETTE AVE.
PASSAIC, NJ 07055
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/18/2003 |
|
PADILLA, OSCAR aka BUSTAMENTE, OSCAR PADILLA (RN)
523 CENTER STREET
SOUTH AMBOY, NJ 08879
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/6/2024 |
Permanent |
PADUANO JR., FRANCIS P. (RPH)
2020 BALMORAL AVE.
UNION, NJ 07083
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/16/1986 |
Permanent |
PADVA-GERMAN, ANNA (DDS)
446 DUBLIN PLAZA
SECAUCUS, NJ 07094
NPI-1043382039 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
12/14/2009 |
3/24/2021 |
PADVA-GERMAN, ANNA (DDS)
446 DUNLIN PLAZA, 446H
SECAUCUS, NJ 07094
NPI-1043382039 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
10/15/2014 |
3/24/2021 |
PAGANO, NICOLE (RN)
531 PARKWAY AVENUE
TRENTON, NJ 08618
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2009 |
|
PAGONZAGA, GLORIA (CHHA)
313 OLD BERGEN ROAD, APT. 2
JERSEY CITY, NJ 07305
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
PAKETT, NEIL (DMD)
777 WEST GERMANTOWN PIKE, APT. 530
PLYMOUTH MEETING, PA 19462
NPI-1184934663 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
PALMA, HARVIN J. (LPN)
7529 PARK AVENUE
PENNSAUKEN, NJ 08109
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/9/2025 |
|
PALMER, AMANDA (LPN)
14 E. MAIN STREET, APT. 4
CLINTON, NJ 08809
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/13/2019 |
|
PALMER, THOMAS #14570-003 (RN)
FPC PENSACOLA, PO BOX 3949
PENSACOLA , FL 32516
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/29/2017 |
|
PAMIKIMUKKALA, VIJAY (RPH)
3 PENROSE COURT
EDISON, NJ 08820
NPI-1598087272 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/13/1999 |
|
PANCELLI, JOHN M. (MD)
WEST JERSEY HOSPITAL
CAMDEN, NJ 08104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
DECEASED |
PANEZAI, FAZAL (MD)
431 FAWNS RUN
MORGANVILLE, NJ 07751
NPI-1710069760 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
3/4/2024 |
6/10/2024 |
PANEZAI, FAZAL (MD)
431 FAWNS RUN
MORGANVILLE, NJ 07751
NPI-1710069760 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/11/2024 |
|
PANGANIBAN, ARMANDO (RN)
CYPRESS RD.
TOMS RIVER, NJ 08753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/11/2007 |
Permanent |
PANICHELLA, ANTHONY G. (COUNSELOR)
739 S. WHITE HORSE PIKE,
AUDUBON, NJ 08106
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/20/2006 |
|
PANIGRAPHY, ASHOK (MD))
FCI MILAN, P.O. BOX 1000
MILAN, MI 48160
NPI-1174559108 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/18/2025 |
|
PANITCH, EDWIN (RPH)
8 POINT OF WOODS DRIVE
NORTH BRUNSWICK, NJ 08902
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
PANJWANI, HARRY K. (MD)
EAST 42 FAIRVIEW TERRACE
PARAMUS, NJ 07652
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/24/1999 |
Permanent |
PANOS, SPYROS (MD)
#69361-054 USP CANAAN, PO BOX 300
WAYMART, PA 18472
NPI-1497753149 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
PAPPALARDO, PETER S. (MD)
4 SOUTH AIRMONT RD
SUFFERN, NY 10901
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
PARADISO, NINO
57 POPLAR DRIVE
MORRIS PLAINS, NJ 07950
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/9/2016 |
|
PARASHOS, LINDA (RN)
514 9TH AVENUE
LINDENWOLD, NJ 08021
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2001 |
|
PARCHMENT, ALFRED (MD)
1140 BURNT TAVERN ROAD
BRICK, NJ 08724
NPI-1073587242 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/25/2016 |
|
PAREDDY, SATYAPAL R. (RPH)
279 REYNOLDS AVENUE
PARSIPPANY, NJ 07054
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
5/14/2024 |
|
PAREKH, CHANDRAKANT (DDS)
6529 GERMANTOWN AVENUE
PHILADELPHIA, PA 19119
NPI-1144386178 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
PARIDA, SAROJ K.
USP LEWIS-PO BOX 1000
LEWISBURG, PA 17837
NPI-1013975549 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2013 |
|
PARIKH, BIPIN (MD)
224 LAFAYETTE STREET
WILLISTON PARK, NY 11596
NPI-1962555193 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/20/2010 |
|
PARIKH, BIPIN J. (MD)
224 SOUTH LAFAYETTE STREET
WILLISTON PARK, NY 11596
NPI-1962555193 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/9/2008 |
|
PARIKH, MANUPRASAD (RPH)
209 STOKES FARM ROAD
FRANKLIN LAKES, NJ 07417
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/20/2004 |
9/5/2017 |
PARKOFF & HAMMER P A
253 ROSEVILLE AVE
NEWARK, NJ 07107PARKOFF, MICHAEL A. (DMD)
68 MAPLEWOOD BLVD
SUFFERIN, NY 10901
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/7/1984 |
Permanent |
PARQUER, HORACE T (LPN)
1402 ROUTE 9 SOUTH
CAPE MAY COURT HOUSE, NJ 08210
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/29/2022 |
|
PASCUCCI, LAVERNE (CHHA)
160 JAMES STREET
TOMS RIVER, NJ 08753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
PASSAFIUME, DANIEL J.
42 SPRUCE STREET
JAMESBURG, NJ 08831
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/20/2022 |
|
PASSAS, ANASTASIA ALEXANDRA a/k/a STACEY PASSAS
880 W. BOWEN BLVD.
FAYETTEVILLE, AR 72703
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/20/2024 |
|
PATANKAR, SANJIV (MD)
61 HARDWICK DRIVE
KENDALL PARK, NJ 08824
NPI-1255429361 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/19/2017 |
|
PATEL, ANILKUMAR K. (CHHA)
8 WOODSTONE LANE
BURLINGTON, NJ 08016
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/25/2023 |
Permanent |
PATEL, ARUNA S. (MD)
725 NORTH BROAD STREET
ELIZABETH, NJ 07208
NPI-1770568610 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/26/2008 |
|
PATEL, ASHOKKUMAR R.
YARDLEY STREET
EDISON, NJ 08820
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/10/2007 |
Permanent |
PATEL, BELA (RPH)
1701 COTTMAN AVENUE
PHILADELPHIA, PA 19111
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/9/2015 |
|
PATEL, BHARAT KUMAR (RPH)
140 RIVERSIDE BLVD.
NEW YORK, NY 10069
NPI-1962729731 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/20/2014 |
|
CLIN-MED LABORATORIES INC
40 GALESI DRIVE
WAYNE, NJ 07470PATEL, CHANDRAKANT
40 GALESI DRIVE
WAYNE, NJ 07470
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
3/28/2000 |
12/12/2007 |
PATEL, CHIRAG
16 SNEIDER ROAD
WARREN, NJ 07059
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
4/2/2012 |
|
PATEL, CHIRAG J.
16 SNEIDER ROAD
WARREN, NJ 07059
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/20/2015 |
|
PATEL, DINESH R. (MD)
3 BRIGHTON COURT
LIVINGSTON, NJ 07039
NPI-1285702829 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/27/2017 |
3/14/2023 |
PATEL, DINESH R. (MD)
3 BRIGHTON COURT
LIVINGSTON, NJ 07039
NPI-1285702829 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/17/2012 |
3/14/2023 |
PATEL, DINESH R. (MD)
835 CLINTON AVENUE
NEWARK, NJ 07108
NPI-1285702829 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2014 |
3/14/2023 |
PATEL, HARISH AKA HARRIS, PAUL (MD)
GB-46 PO BOX 26010
BEAUMONT, TX 77720
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/20/2006 |
|
PATEL, KAIVAL
413 NEWBURGH COURT, #413X
WEST NEW YORK, NJ 07093
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/14/2024 |
|
PATEL, KUMAR a.k.a. PATEL, MINAL a.k.a. PATEL, MINALKUMAR
FDC MIAMI P.O. BOX 01920
MIAMI, FL 33101
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/20/2023 |
|
PATEL, MAHESH (MD)
3 PINE VALLEY WAY
FLORHAM, NJ 07932
NPI-1942202841 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/26/2015 |
11/9/2020 |
PATEL, MEHMOOD (MD)
201 MIDDLETON ROAD
LAFAYETTE, LA 70503
NPI-1225074859 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/26/2010 |
|
PATEL, MINAL a.k.a. PATEL, KUMAR a.k.a PATEL, MINALKUMAR
FDC MIAMI P.O. BOX 01920
MIAMI, FL 33101
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/20/2023 |
|
PATEL, PARESH R. (DMD)
295 MAIN STREET
METUCHEN, NJ 08840
NPI-1134106511 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/22/2014 |
11/10/2023 |
PATEL, PARESHCHANDRA
8 NOTTINGHAM ROAD
EDISON, NJ 08820
NPI-1306073200 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/21/2016 |
|
PATEL, PRAVIN K. (MD)
904 #35 IVY RIDGE RD
SYRACUSE, NY 13210
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/19/2002 |
4/1/2022 |
PATEL, RAMBEN D. (LPN)
505 WEST MINISTER BLVD.
PARLIN, NJ 08859
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2000 |
|
PATEL, RAMESH SHANKER BHAI (RN)
PO BOX 5564
OLD BRIDGE, NJ 08857
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2001 |
|
PATEL, RITA (RPH)
4 HAUSER LANE
MATAWAN, NJ 07747
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/20/2017 |
10/19/2017 |
PATEL, RITA (RPH)
4 HAUSER LANE
MATAWAN, NJ 07747
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/10/2016 |
2/17/2017 |
PATEL, RITA (RPH)
4 HAUSER LANE
MATAWAN, NJ 07747
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/19/2017 |
|
PATEL, SANJAY (RPH)
16 SPLIT ROCK ROAD
UPPER SADDLE RIVER, NJ 07458
NPI-1316335961 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/26/2016 |
|
PATEL, SANJAY I. (RPH)
63 HEATHERDELL ROAD
ARDSLEY, NY 10502
NPI-1316335961 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/20/2006 |
|
PATEL, SAURABH (MD)
56 ROANOKE STREET
WOODBRIDGE, NJ 07095
NPI-1790795227 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/13/2023 |
|
PATEL, SHIRJAY (CHHA)
703 NEW DOVER ROAD
EDISON, NJ 08820
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
PATEL, VIJAY
65 W. LINCOLN AVENUE
ROCKAWAY, NJ 07866
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2016 |
|
PATEL, VITTHAL I. (RPH)
ST. GEORGE AVE, APT. 141
AVENEL, NJ 07001
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2004 |
Permanent |
PATHAK, VINEETA (MD)
533 LEAWOOD AVENUE
TOMS RIVER, NJ 08755
NPI-1104922939 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/29/2019 |
|
PATHARKAR, MANOJ (MD)
16 LINDA COURT
LAURENCE HARBOR, NJ 08879
NPI-1598808339 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/19/2016 |
Permanent |
PATIN, YURY (MD)
45 BEVERLY ROAD
SUMMIT, NJ 07901
NPI-1548325400 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/26/2009 |
|
PATTERSON JR., ARTHUR (DC)
8 FELLOWWOOD WAY
HOLMDEL, NJ 07733
NPI-1164628822 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
7/18/2014 |
|
PATTERSON, KELEE (RN)
577 EAST ROAD
BELFORD, NJ 07718
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/28/2017 |
|
PATTERSON, KRISTIN LEA (RN)
1405 EXPOSITION DRIVE
WILLIAMSTOWN, NJ 08094
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2023 |
|
PAUL, DAVID M. (MD)
434 RAHWAY AVENUE
WOODBRIDGE, NJ 07095
NPI-1124355250 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/22/2002 |
|
PAYANO, VIANNE AKA AMPARO, VIANNE (CHHA)
710 EAST 18TH STREET
PATERSON, NJ 07501
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
PEACOCK, DENISE (RN)
9331 GLENLOCH STREET
PHILADELPHIA, PA 19114
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
PEARSON, KATIE (LPN)
229 SNOOKS HILL RD.
LEWISTOWN, PA 17044
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
PEARSON, SHAMERA (CHHA)
2824 N. BAMBREY STREET
PHILADELPHIA, PA 19132
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/16/2019 |
Permanent |
PEART, HAROLD (LCSW)
3 HARRISON PARK LANE
BURLINGTON, NJ 08016
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
3/17/2000 |
|
PEART, HAROLD (LCSW)
415 KEIM BOULEVARD
BURLINGTON, NJ 08016
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/1999 |
|
MARVIN PECK'S PHARMACY
335 GEORGE STREET
NEW BRUNSWICK, NJ 08901PECK, MARVIN (RPH)
335 GEORGE STREET
NEW BRUNSWICK, NJ 08901
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
PECKLER, MYLES (RN)
112 W 4TH STREET
CLIFTON, NJ 07011
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/27/2022 |
|
PELAEZ, LORELEY (CHHA)
58 S. VALLEY ROAD
WEST ORANGE, NJ 07052
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/5/2023 |
|
PELIZZARI, JOHN J. (DO)
16 MOONBEAM DRIVE
LEWISTOWN, PA 17044
NPI-1235190638 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/30/2022 |
|
PELLEGRINO, TAMMY (RN)
2423 SHADY LANE APT P
ATCO, NJ 08004
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/20/2003 |
|
PELLICANO, PAUL J. (MD)
120 MILLBURN AVE. STE M1
MILLBURN, NJ 07041
NPI-1316282783 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
PEMBERTON, COLIN (MD)
500 ORANGE STREET
NEWARK, NJ 07107
NPI-1891935557 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/28/2017 |
4/26/2018 |
PEMBERTON, COLIN (MD)
2 DEVONSHIRE TERRACE
WEST ORANGE, NJ 07052
NPI-1891935557 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/8/2019 |
|
PENA, CARMEN F. (DDS)
800 76TH ST., 2ND FLOOR
NORTH BERGEN, NJ 07047
NPI-1871750166 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2000 |
9/15/2015 |
PENALES, AMANDO D.
BAYSIDE PRISON PO BOX F-1
LEESBURG, NJ 08327
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/9/2014 |
|
PENALVER, FAITH (RN)
4 MAPLE COURT
ROOSEVELT, NJ 08555
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/19/2005 |
|
PENFIELD, JOHN (DO)
25 POCONO ROAD
DENVILLE, NJ 07834
NPI-1528078839 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
3/6/2014 |
3/2/2018 |
PENFIELD, JOHN (DO)
25 POCONO ROAD
DENVILLE, NJ 07834
NPI-1528078839 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
3/2/2018 |
PENICO, PETER (MD)
300 MAIN STREET
MILLVILLE, NJ 08332
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/24/1978 |
DECEASED |
PENNANT GRAY, SONIA (CHHA)
491 PARK AVENUE
EAST ORANGE, NJ 07017
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/26/2019 |
Permanent |
PEPE, ANTHONY
111 E. MIAMI AVENUE
CHERRY HILL, NJ 08034
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/1/2019 |
|
PERALTA, ARELY (CHHA)
737 PINE STREET
NORTH BRUNSWICK, NJ 08902
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2023 |
|
PERERA, SANTUSHT (MD)
7 GREENHILL ROAD
KINNELON, NJ 07405
NPI-1942311147 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/22/2016 |
Permanent |
PEREZ, HUMBERTO T. (MD)
3 MARINA KY
SECAUCUS, NJ 07094
NPI-1326121872 / 1629361290 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/12/2025 |
Permanent |
PEREZ, JORGE (MD)
213 14TH STREET
PALISADES PARK, NJ 07650
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/18/2004 |
|
PEREZ, JUANA (CHHA)
510 25TH STREET
UNION CITY, NJ 07087
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
PERLMAN, BERNARD (MD)
42 OAKMONT ROAD
YARMOUTH PORT, MA 02675
NPI-1477579456 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/3/2000 |
9/12/2017 |
PERRIN, DOUGLAS M. (CHHA)
1801 LAURAL ROAD
LINDERWOLD, NJ 08021
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2002 |
|
PERRY, ELSWETTA (CHHA)
291 NORTH PARK STREET, 1ST FLOOR
EAST ORANGE, NJ 07017
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/12/2018 |
|
PERRY, MARINA (RN)
633 FOXTON COURT
WEST DEPTFORD, NJ 08051
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/4/2025 |
|
PERTCHIK, ALAN (MD)
66 MANITTO PLACE
OCEANPORT, NJ 07757
NPI-1861467664 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/16/2025 |
Permanent |
PESCIOTTA, BARBARA ANN (RPH)
992 VAUGHN AVENUE
TOMS RIVER, NJ 08753
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/18/2006 |
|
PESCIOTTA, ROY THOMAS (RPH)
992 VAUGHN AVENUE
TOMS RIVER, NJ 08753
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/18/2006 |
|
PETERS, MEAGHAN (RN)
707 BUCHANAN STREET, APT. 2
TOMS RIVER, NJ 08753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/29/2019 |
|
PETERSON, PETHINA (CHHA)
289 MLK DRIVE
JERSEY CITY, NJ 07305
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2004 |
|
PETIT, MADELINE (CNA)
228 70TH STREET 2ND FL.
GUTTENBERG, NJ 07093
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/7/2008 |
|
PETRUCELLI, SALVATORE (MD)
201 LYONS AVENUE
NEWARK, NJ 07112
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/2/2000 |
Permanent |
PETTERSON, LINDA A. (RN)
700 PARK BLVD.
CHERRY HILL, NJ 08002
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2002 |
|
PETTIS, LARRY (MD)
204 DALE ROAD #1
MOUNT HOLLY, NJ 08060
NPI-1053433276 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/11/2025 |
|
PFAUTZ, JOANNA (LPN)
1595 BREAKERS DRIVE, #A
MANAHAWKIN, NJ 08050
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2018 |
|
PFUND, SUSAN (RN)
90 W 56TH STREET
BAYONNE, NJ 07002
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/25/2023 |
Permanent |
PHARES, ALYSSA (RN)
21 WOODLAND WAY
DAYTON, NJ 08810
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2002 |
|
PHILEMON, EVELYNE (RN)
70 ASTOR PLACE
SPRINGFIELD, NJ 07081
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/14/2024 |
|
PHILEMON, MENAHEM (CHHA)
265 KING VILLAGE
BUDD LAKE, NJ 07869
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/18/2018 |
|
PHILIPPE, ADELINE (CHHA)
61 CLEVELAND STREET, APT. 2E
ORANGE, NJ 07050
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/12/2018 |
|
PHILIPPE, IRLANDE (RN)
29 ELM STREET
WEST ORANGE, NJ 07052
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/22/2017 |
|
PHILLIPS, RONALD (DO)
718 HAVEN PLACE
LINDEN, NJ 07026
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/8/1999 |
Permanent |
PHIPPS JR., ERNEST (MD)
130 FORD ROAD
HOWELL, NJ 07731
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2004 |
|
PIACENTILE, JOSEPH (MD)
578 BIG OAK ROAD
YARDLEY, PA 19067
NPI-1265607410 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/17/1995 |
Permanent |
PIAZZA, GARY G. (DO)
7 CARRIAGE PLACE
EDISON, NJ 08820
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/20/1998 |
Permanent |
PICARIELLO, JOSEPH
1202 FOX CHASE LANE
WHIPPANY, NJ 08981
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/9/2000 |
6/1/2016 |
PIERCE, BRUCE (MD)
4 STEEPLE CHASE ROAD
MILLSTONE TOWNSHIP, NJ 08535
NPI-1437159506 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/25/2025 |
|
PIERCE, JACQUELINE (CHHA)
1066 NORTH 28TH STREET
CAMDEN, NJ 08105
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/14/2017 |
|
PIERCE, LESLIE (CHHA)
511 1ST AVENUE, APT. #3-W
ASBURY PARK, NJ 07712
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/6/2018 |
|
PIERRE, BRADLEY
37 ALPINE DRIVE
CLOSTER, NJ 07624
NPI- |
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/19/2024 |
|
PIERRE, OTILIEN (CHHA)
454 SOUTH OLDEN AVENUE
TRENTON, NJ 08609
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
PIERSON, GEORGE T. (DO)
5 RAINBOW TRAIL
SPARTA, NJ 07871
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/2/1988 |
DECEASED |
PIETRUSZEWSKI, WILLIAM
5 E. ELK DRIVE
OAK RIDGE, NJ 07438
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
10/19/2023 |
|
PILATE, MICHAEL
1309 MULBERRY LANE
WILLIAMSTOWN, NJ 08904
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2022 |
|
PIMPONG, SWANZELLA (RN/LPN/CHHA)
14 3RD STREET, FLOOR 1
NEWARK, NJ 07107
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/3/2017 |
|
PINEDA, FRANCISCA
151 TRAILS END
NEW CITY, NY 10956
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/18/2001 |
|
PINKERTON, MARION (LPN)
410 THOMAS AVENUE
RIVERTON, NJ 08077
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2003 |
|
PINNAMARAJU, VENKATA (RPH)
5324 FOX RIDGE ROAD
ROANOKE, VA 24018
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/24/2017 |
|
PIOTROWSKI, DENISE (CHHA)
100 EAST MAIN STREET
MARLTON, NJ 08053
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/31/2017 |
|
PIRLAMARLA, JYOTI (MD)
77 JACKSON MILLS ROAD
FREEHOLD, NJ 07728
NPI-1952349425 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/21/2016 |
|
PIRMISASHVILLI (CHHA)
43 LINDEN STREET
FORDS, NJ 08863
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
PIROVOLAS, NICHOLAS (RPH)
30 DWIGHT DRIVE
WEST DEAL, NJ 07712
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/16/2000 |
|
PIROVOLOS, NICHOLAS (RPH)
30 DWIGHT DRIVE
OCEAN, NJ 07712
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2002 |
|
PISANI, LOUIS (RPH)
2 E. FRANKLIN COURT
GARDEN CITY, NY 11530
NPI-1215250709 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/19/2000 |
|
PISANI, LOUIS (RPH)
PO BOX 737513
ELMHURST, NY 11373
NPI-1215250709 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/3/2016 |
|
PIUCK, CHARLOTTE L. (MD)
593 RAMAPO VALLEY ROAD
OAKLAND, NJ 07436
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/25/2001 |
Permanent |
PIZUTELLI, HARRY
80 CLAUDIA LANE
MANAHAWKIN, NJ 08050
NPI- |
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/26/2024 |
|
PIZZARELLI, ANGELA D.
1111 BOND STREET
ASBURY PARK, NJ 07712
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/18/2001 |
Permanent |
PLANT, CHINIA
2013 LOGAN STREET
HARRISBURG, PA 17102
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
PLINIO, STEVEN (DC)
655 AMBOY AVENUE
WOODBRIDGE, NJ 07095
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/30/1999 |
DECEASED |
PLOTNIK, PETER J. (MD)
276 COLERIDGE STREET
BROOKLYN, NY 11235
NPI-1407019813 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/23/2000 |
Permanent |
PLOTTS, LISA AKA FROSCH, LISA (RN)
111 BEECHWOOD AVENUE
OAKLYN, NJ 08107
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/18/2001 |
|
PLUCINSKI, PATRICIA (LPN)
201 HAEGELE PLACE
MOUNT ROYAL, NJ 08061
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/20/2009 |
Permanent |
POBER, JOSEPH (MD)
126 LINDEN STREET
RIDGEWOOD, NJ 07450
NPI-1194948703 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/14/2019 |
|
POET, ALBERT (MD)
EAST BAY AVENUE
MANAHAWKIN, NJ 08050
NPI-1134270903 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/10/2007 |
Permanent |
POFF, SHIABON (LPN)
48 CHESTNUT STREET
WARETOWN, NJ 08758
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/22/2017 |
|
POGGIOLI, STEPHAN
431 ACADEMY TERRACE
LINDEN, NJ 07036
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/18/2004 |
|
SUN REHAB, INC.
BILLINGS AVENUE, APT. 619A
PAULSBORO, NJ 08062POH-EIKOM, VICKI
BILLINGS AVE., APT. 619A
PAULSBORO, NJ 08062
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/11/2000 |
Permanent |
POH-EIKOM, VICKI
BILLINGS AVE., APT. 619A
PAULSBORO, NJ 08062
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/29/1999 |
Permanent |
POLANSKY, IRVING (RPH)
260 MAIN ST
KEANSBURG, NJ 07734
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/9/1985 |
Permanent |
POLINISTE, JESULA L. (CHHA)
63 N. WALNUT STREET, APT 9
EAST ORANGE, NJ 07017
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/4/2025 |
|
POLISE, VINCENZO (RPH)
33 HARRISON ROAD
KINNELON, NJ 07405
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/31/2015 |
|
POLISHUK, ANDRIJ A.
649 PULHAM COURT #A
MANCHESTER, NJ 08759
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/8/2008 |
|
POLLACK, EARL T. (DMD)
171 N. LANSDOWNE AVE.
LANSDOWNE, PA 19050
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/7/1986 |
Permanent |
POLLACK, JOSEPH (DPM)
P. O. BOX 11401
YARDVILLE, NJ 08628
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/30/1982 |
9/30/1987 |
POLLEN, PHILIP
245 ROUTE 9
MORGANVILLE, NJ 07751
NPI-1245341924 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/28/2013 |
|
POOLE, JAMES (RN)
34 SOUTH 2ND STREET, APT. 5
DEQUESNE, PA 15110
NPI-1639367972 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
POOLE, KENDRA (CHHA)
222 COOLIDGE AVENUE
TRENTON, NJ 08618
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/23/2018 |
|
POPICK, ALAN (DO)
1532 CREEKSIDE ROAD
WHITEHALL, PA 18052
NPI-1194789214 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/11/2016 |
|
POROGER, EMMA (DO)
59 LINWOOD ROAD
STATEN ISLAND, NY 10308
NPI-1669572368 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/12/2016 |
|
PORTWOOD, ROBERT (MD)
11006 GENOA AVENUE
LUBBOCK, TX 79424
NPI-1740519628 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/15/2022 |
5/27/2025 |
POSNER, ROBERT S. (DDS)
53 WESTFIELD AVENUE
CLARK, NJ 07066
NPI-1740518992 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/23/1999 |
Permanent |
POTACCO, PHILIP (DC)
54 CHURCH STREET
SOUTH ORANGE, NJ 07079
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/20/2003 |
|
POTTER, DIANE (LPN)
215 FAIRFIELD LANE
KING WILLIAM, VA 23086
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2009 |
|
POWELL, STEVEN (MD)
949 DUNBAR HILL ROAD
GRAHAM, NH 03753
NPI-1477649168 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/15/2024 |
|
POWELL, WILLIE (MFT)
2130 MILLBURN AVENUE
MAPLEWOOD, NJ 07040
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/12/2016 |
Permanent |
PRAVETZ, MICHAEL (MD)
531 GATES STREET
PHILADELPHIA, PA 19128
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/5/2001 |
Permanent |
PRENSKY, JOSHUA (DMD)
28-10 HIGH STREET
FAIRLAWN, NJ 07410
NPI-1578761961 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/17/2009 |
|
PRENSKY, JOSHUA (DMD)
2810 HIGH ST.
BERGEN, NJ 07410
NPI-1578761961 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/29/2013 |
|
PRESILLA, ALEJANDRO (MD)
15 FULTON STREET
WEEHAWKEN, NJ 07086
NPI-1902835747 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/30/2010 |
4/30/2013 |
PRESS, STUART M. (MD)
1525 E. PUTNAM AVE #206
OLD GREENWICH, CT 06870
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/1/2009 |
|
PRESSLEY, BRITTANY (CHHA)
703 CATALINA DRIVE
SOMERDALE, NJ 08083
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/29/2024 |
|
PRESSLEY, CAMOMILE D. (LPN)
174B WILLOW TURN
MOUNT LAUREL, NJ 08054
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2023 |
|
PRIME, ANDREW
100 BANKS AVE., APT 1264
ROCKVILLE CENTER, NY 11570
NPI- |
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/19/2024 |
|
PRINTZ, BRUCE I. (DO)
400 GILL LANE
ISELIN, NJ 08830
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
6/6/2004 |
|
PRITCHARD, JOSEPH
69 TALLWOOD DRIVE
MEDFORD, NJ
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
5/9/2002 |
12/10/2014 |
CUSTOM SHOE SERVICE
218 HALSEY STREET
NEWARK, NJ 07102PROSKUROVSKY, BORIS
218 HALSEY STREET
NEWARK, NJ 07102
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/25/1998 |
|
CUSTOM SHOE SERVICE
218 HALSEY STREET
NEWARK, NJ 07102PROSKUROVSKY, BORIS
218 HALSEY STREET
NEWARK, NJ 07102
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/4/1997 |
Permanent |
PROTAS, OLEG (CHHA)
407 LIBERTY LANE
MARLTON, NJ 08053
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/26/2017 |
|
PROVOST, LAURIE (LPN)
10 BALTIMORE BLVD
SEA GIRT, NJ 08750
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
1/24/2014 |
|
PRZADOWSKA-KOKINDA, ELIZABETH M. (RN)
1106 PARKSIDE AVENUE
TRENTON, NJ 08618
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/20/2005 |
|
PUCCI, BRIAN M. (RPH)
14 RAND RD.
PINE BROOK, NJ 07058
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2005 |
9/19/2014 |
PUCCIO, MATTHEW
17 TRADE WINDS DRIVE
RANDOLPH, NJ 07869
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/25/2023 |
|
PUCCIO, MATTHEW R.
P.O. BOX 1000
OTISVILLE, NY 10963
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/20/2023 |
|
PUENTES, ELENA (CHHA)
374B HAMILTON STREET
SOMERSET, NJ 08873
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/14/2007 |
|
PUGLIESE, GIROLAMO (MD)
103 MAIN STREET
KEYPORT, NJ 07735
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/22/1999 |
DECEASED |
PUIG, TAYLOR (CHHA)
21 OVERVIEW COURT, APT. 21
BAYVILLE, NJ 08721
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/16/2021 |
|
PUIG, TAYLOR (PHARM TECH)
21 OVERVIEW COURT, APT. 21
BAYVILLE, NJ 08721
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/23/2021 |
|
PULVIRENTI, FRANCESCA M.
212 8TH STREET
SURF CITY, NJ 08008
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/29/2005 |
|
PURNESS, TIFFANY (CHHA)
105 BLACKWOOD-CLEMONTON ROAD #704
LINDENWOLD, NJ 08021
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/26/2018 |
|
PURPERA, FRANK CRAIG (MD)
FCI GILMER P.O. BOX 600
GLENVILLE, WV 26351
NPI-1194957761 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/20/2019 |
|
QAYYUM, ABDUL (RPH)
960 COUNTRY CLUB DRIVE
TEANECK, NJ 07666
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/27/2000 |
Permanent |
QUARTARARO, LOUIS (MD)
37 WEST CENTURY ROAD
PARAMUS, NJ 07652
NPI-1467460089 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/5/2019 |
|
QUAYE, EMMANUEL a/k/a EMMANUEL K. EPHIRAM (CHHA)
84 WINDING WOOD DRIVE, APT 2B
SAYREVILLE, NJ 08872
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/25/2025 |
|
QUEEN, RYSHAUN (CHHA)
6 KINGSBURY SQUARE, APT. #1-D
TRENTON, NJ 08611
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/10/2018 |
|
QUEST, BRITTANY (CHHA)
379 SANFORD AVENUE
NEWARK, NJ 07106
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
QUIJADA, CARLOS (COUNSELOR)
106 SPRING VALLEY AVE, #1
HACKENSACK, NJ 07601
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/20/2012 |
4/9/2019 |
QUINN, JOHN C. (RN)
437 HARRISTOWN ROAD
GLEN ROCK, NJ 07452
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2006 |
|
QUINONES, ANEL
48 GRAND STREET
GARFIELD, NJ 07026
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/11/2001 |
Permanent |
QUINONES, ELIZABETH (CHHA)
210 BOND STREET
ELIZABETH, NJ 07206
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
QURESHI, SHAMS (MD)
1084 MAIN AVENUE
CLIFTON, NJ 07011
NPI-1194743377 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
1/27/2012 |
|
RAAB, TERRI A. (LPN)
3 MILL ROAD
JAMESBURG, NJ 08831
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/20/2004 |
|
RABAH, MOHAMMAD (DMD)
55 ENCLOSURE STREET
NUTLEY, NJ 07110
NPI-1669684114 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/3/2017 |
8/23/2019 |
RADICS JR., ALEXANDER (LPN)
13 WHITE HAVEN PLACE
BLOOMINGDALE , NJ 07403
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/30/2019 |
Permanent |
RADOWITZ, MARK A. (DC)
76 CHICHESTER ROAD
MONROE TOWNSHIP, NJ 08831
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/4/2007 |
|
RAFLA, MAGDY
3 KULESSA COURT
EAST BRUNSWICK, NJ 08816
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
8/22/2011 |
|
RAHMAN, RONALD (MD)
20 SUSSEX AVENUE
VOORHEES, NJ 08043
NPI-1437378502 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/29/2013 |
|
RAHMAN, SAHID (CHHA)
29 ROBIN COURT
PISCATAWAY, NJ 08854
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/29/2018 |
|
RAIA, JOSEPH (MD)
56 GRAFTON AVENUE
NEWARK, NJ 07104
NPI-1225126717 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/28/2014 |
|
RAJA, ABDUL, H.
53 FULHAN LANE
HOLBROOK, NY 00741
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/29/2003 |
Permanent |
RAJU, SRINIVASA (RPH)
115 RIVERWALK WAY D2
CLIFTON , NJ 07014
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2017 |
|
RAMACHANDRA, NANDAVAR (MD)
741 ROUTE 18 S.
EAST BRUNSWICK, NJ 08816
NPI-1235219809 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/18/2014 |
11/5/2018 |
RAMACHANDRA, NANDAVAR (MD)
165 SALEM ROAD
NORTH BRUNSWICK, NJ 08902
NPI-1235219809 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/21/2020 |
|
RAMACHANDRA, NANDAVAR K (MD)
120 AMBERLY DR, UNIT K
MANALAPAN, NJ 07726
NPI-1235219809 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2021 |
|
RAMANADHAM, ARUNA R. (MD)
9 MOUNTAINVIEW DRIVE
LIVINGSTON, NJ 07039
NPI-1609157692 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/12/2000 |
Permanent |
RAMAS, EDWIN L. (LPN)
789 MITCHEL AVE.
UNION, NJ 07083
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
7/17/2009 |
7/17/2014 |
RAMIREZ, MARIELA (CHHA)
775 EAST 3RD AVENUE, APT. A
ROSELLE , NJ 07203
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/9/2018 |
|
RAMOS, JEANETTE (CHHA)
234 WILMONT AVENUE
CAMDEN, NJ 08105
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2017 |
|
RAMOS, REYNALDO
52 ABINGTON CT.
MAYS LANDING, NJ 08330
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
8/12/2013 |
|
RAMOS, ROLANDO
85 SHERMAN AVENUE
TEANECK, NJ 07666
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2004 |
|
RAMPERSAD, LAKSHMINARINE
11 APPLETREE LANE
LANDING, NJ 07850
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/20/2000 |
|
RAND, DOV (MD)
667 EAGLE ROCK AVENUE
WEST ORANGE, NJ 07052
NPI-1043311145 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
2/15/2012 |
|
RAND, DOV (MD)
667 EAGLE ROCK AVENUE
WEST ORANGE, NJ 07052
NPI-1043311145 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
9/3/2013 |
|
RAND, DOV (MD)
840 STONEWALL CT G
FRANKLIN LANES, NJ 07417
NPI-1043311145 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
5/7/2014 |
|
RAND, ELIAS
1401 OCEAN AVENUE
BROOKLYN, NY 11230
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
RAO, BHAGAVATHI MALINI aka RAO, MALINI PRASAD (MD)
555 WEST MADISON ST., APT 2310
CHICAGO, IL 60661
NPI-1649456005 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2024 |
|
RAO, MALINI (MD)
444 WASHINGTON BOULEVARD
JERSEY CITY, NJ 07310
NPI-1649456005 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/12/2016 |
|
RAO, MALINI PRASAD aka RAO, BHAGAVATHI MALINI
555 WEST MADISON ST., APT 2310
CHICAGO, IL 60661
NPI-1649456005 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2024 |
|
RASCHID, SOHAEL (MD)
1126 KENNEBEC DRIVE
CHAMBERSBURG, PA 17201
NPI-1104851369 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
RASHEED, SYED ADIL (MD)
127 MOUNTAINSIDE DRIVE
POMPTON LAKES, NJ 07442
NPI-1669511036 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/22/2024 |
|
RASLAN, SALMA (CHHA)
1165 US HIGHWAY 22, APT. 46
NORTH PLAINFIELD, NJ 07060
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/5/2023 |
|
RASNER, STEVEN (DMD)
1055 NORTH PEARL ST
BRIDGETON, NJ 08401
NPI-1114022803 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/16/1984 |
4/5/2018 |
RASOULINEJAD, ZEHRAH T. (DDS)
P.O. BOX1217
ALPINE, NJ 07620
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2003 |
|
RATCHFORD, WILLIAM B. (MD)
PO BOX 2063
GLENVIEW, IL 60025
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
6/4/1998 |
|
RAUH-BRIGHAM, SUSAN (RN)
4 BRECKENRIDGE DRIVE
SHAMONG, NJ 08088
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2001 |
|
RAVAL, KAWU
600 PAVONIA AVENUE
JERSEY CITY, NJ 07306
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
|
RAVIN, JOHN M. (MD)
9600 STERLING RIDGE AVE.
LAS VEGAS, NV 89129
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/19/2004 |
|
RAY, DEBRA (RN)
32 KAYWIN AVENUE
HAWTHORNE, NJ 07506
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/19/2004 |
|
RAYNOR, MARCELLA
660 BROAD STREET, APT. 811
HARRISBURG, PA 17102
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
RAZIQ, RAFIK
NORTHERN STATE PRISON
NEWARK, NJ 07115
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/1/2002 |
Permanent |
REA, MICHAEL (MD)
444 MANSFIELD AVENUE
HADDONFIELD, NJ 08033
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/11/2001 |
DECEASED |
REATH, ERIN R. (RN)
7705 SABRE DRIVE
KNOXVILLE, TN 37919
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/18/2005 |
|
REAVES, LORI A. (MD)
FPC ALDERSON - GLEN RAY RD
ALDERSON, WV 24910
NPI-1417959503 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/7/2014 |
|
REBA, GARY J. (DDS)
TITUS LANE
PLAINSBORO, NJ 08536
NPI-1285852541 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/20/2007 |
|
REBER-MADENYIKA, EDITH (RN)
216 HALE STREET
PENNINGTON, NJ 08534
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
4/7/2022 |
|
RECK, FRANZ (DMD)
17 CENTER STREET
HIGHLANDS, NJ 07732
NPI-1528248457 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/2019 |
7/21/2020 |
REDDEN, DAYJA (CHHA)
1822 SOUTH 7TH STREET
CAMDEN, NJ 08104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/23/2018 |
|
REDDY, PRANATHI (DMD)
6207 SPRUCE MILL DRIVE
MORRISVILLE, PA 19067
NPI-1538321583 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/23/2019 |
7/21/2020 |
REDNOR, GERALD B.
101 KENSINGTON AVENUE
TRENTON, NJ 08618
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
REDONDO, ILEANA (MD)
2421 ROSETTE STREET
FORT LEE, NJ 07024
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/23/2002 |
Permanent |
REED, JUDY
233A MUHAMMAD ALI AVE
NEWARK, NJ 07108
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/15/2005 |
|
REED, STEPHAN NILS (DC)
4722 EAST DELL RD
PHOENIX, AZ 85026
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
DECEASED |
REEVES, WILBURN C.
CREEK ROAD
BRICK, NJ 08724
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/10/2007 |
Permanent |
REGO, RAMON (MD)
6701 BERGENLINE AVENUE
WEST NEW YORK, NJ 07093
NPI-1033227459 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
3/19/2012 |
2/16/2017 |
REHAN, MOHAMMAD
280 MARIN BLVD., APT. 10R
JERSEY CITY, NJ 07302
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
2/23/2024 |
|
REHAN, ZAHEER, A.
280 HENDERSON STREET
JERSEY CITY, NJ 07302
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/10/1999 |
Permanent |
REHMAN, FAROOQ (MD)
225 MAY STREET, SUITE D
EDISON, NJ 08837
NPI-1467581827 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/20/2016 |
2/9/2017 |
REHMAN, FAROOQ (MD)
225 MAY STREET, SUITE D
EDISON, NJ 08837
NPI-1467581827 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/13/2015 |
|
REID, ISON (CHHA)
37 LEO PLACE
LODI, NJ 07644
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/19/2025 |
|
REID, PEACHES (CNA)
11 RUTGERS STREET
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/1/2002 |
|
REINHARD, BARBARA
704 REED COURT
FLEMINGTON, NJ 08822
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/9/2007 |
|
REINHART, JENNIFER (LPN)
70 ROSS AVENUE
HACKENSACK, NJ 07601
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/23/2019 |
|
REITER, RAYMOND D. (MD)
405 MURRAY HILL PKWY#1023
E. RUTHERFORD, NJ 07073
NPI-1841447380 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/22/2001 |
Permanent |
RENNER, ALLISON
1210 OAK ROAD
MANASQUAN, NJ 08736
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/28/2017 |
11/3/2023 |
RENNER, CARL (MD)
61 WALDRON AVENUE
GLEN ROCK, NJ 07452
NPI-1346205705 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/25/2019 |
Permanent |
RENNER, JOANNA (LPN)
300 GARWIN ROAD
WOOLWICH TOWNSHIP, NJ 08085
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/13/2025 |
|
RENZI, CAROLINE M. (DO)
247 CENTER ST
TRENTON, NJ 08611
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/4/1991 |
Permanent |
REVAN-LEWIS, CHAUNDREL (CHHA)
26 NANCY LANE
PISCATAWAY, NJ 08854
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
REYES, BRIANNA (CHHA)
220 WEST BRANCH AVENUE, APT. 111
PINE HILL, NJ 08021
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/5/2019 |
|
REYES, DANNIELL (DC)
5262 HAMILTON S
SAYLORSBURG, PA 18353
NPI-1124053905 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
REYES, MARIA (CHHA)
1207 ATLANTIC AVENUE
CAMDEN, NJ 08104
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/29/2017 |
|
REYES-ARIAS, ARCADIO
286 SUSSEX AVENUE
NEWARK, NJ 07107
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/11/2016 |
|
REZNIKOVA, YELENA (CHHA)
73 MADISON GARDENS
OLD BRIDGE, NJ 08857
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/12/2017 |
|
RHODES, SARE MAE (DMD)
161 BRIDGE STREET
TUNKHANNOCK, PA 18657
NPI-1750572996 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2015 |
|
RIACHI, LABIB (MD)
128 SOUTH EUCLID AVENUE
WESTFIELD, NJ 07090
NPI-1801846597 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/9/2017 |
|
RIACHI, LABIB (MD)
42 RUTGERS AVENUE
COLONIA, NJ 07067
NPI-1801846597 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/9/2018 |
|
RICCIARDI, JUDE (CHHA)
1452 45TH
NORTH BERGEN, NJ 07047
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2002 |
|
RICCIO, PETER (RPH)
17 CASALE DRIAVE, APT R2
WARREN, NJ 07059
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/12/2016 |
|
RICE, SHARONDA M. (CHHA)
3633 HIGHWAY 33
NEPTUNE, NJ 07753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/28/2024 |
|
RICE, STUART N. (MD)
31 LONG HILL ROAD
BASKING RIDGE, NJ 07920
NPI-1366403610 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/22/2025 |
|
RICH, LEO
CEDAR LANE
TEANECK, NJ 07666
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
RICHARDS, AARON (COUNSELOR)
23 WYCOFF STREET
DEAL, NJ 07723
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/20/2001 |
|
RICHARDSON, RUTH (CHHA)
555 E. 27TH STREET, APT. 11
PATERSON, NJ 07514
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/22/2019 |
|
RICHARDSON, YALONDA (CHHA)
52 2ND AVENUE
TOMS RIVER, NJ 08757
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
RICHLINE, AMANNDA (DPM)
4 GREENWICH STREET
BELVIDERE, NJ 07823
NPI-1013040435 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/22/2017 |
|
RICHMAN, HOWARD P. (DPM)
502 N BLACK HORSE PIKE
WILLIAMSTOWN, NJ 08053
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/15/1993 |
Permanent |
RICHSTONE, GEOFFREY (MD)
PO BOX 38, FCI
FORT DIX, NJ 08640
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2002 |
|
RIENZO, FRANCIS (MD)
2164 HIGHWAY 35 STE 2
SEA GIRT, NJ 07850
NPI-1003887068 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/17/2021 |
|
RIGGI, JOSEPH (MD)
36 VARDON WAY
FARMINGDALE, NJ 07727
NPI-1265436638 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/9/2015 |
4/9/2019 |
RIGO, BLADIMIR
FCI-FORT DIX, PO BOX 2000
JOINT BASE MDL, NJ 08640
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/12/2016 |
|
RILEY, BRIDGETT (PHARM TECH)
1801 EGG HARBOR ROAD
LINDENWALD, NJ 08021
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/20/2003 |
|
RIMERMAN, VALERY (MD)
43 DEMAREST AVENUE
CLOSTER, NJ 07624
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/20/2006 |
DECEASED |
RINIER, BOBBY J. (LPN)
1101 MILLMAN BLVD.
DEL HAVEN, NJ 08251
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/11/2025 |
|
RIOS, GUSTAVO ERNESTO (MD)
127 TWEED DRIVE
JACKSONVILLE, NC 28540
NPI-1780648295 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/11/2011 |
|
RIOS, JOSE (MD)
175 SUMMER AVENUE
NEWARK, NJ 07104
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
5/14/1998 |
Permanent |
RIPPS, DANIEL (DDS)
1330 CALHOUN STREET
TRENTON, NJ
NPI-1124293659 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1995 |
Permanent |
RITA, ELANA L. (RN)
73 CHATHAM PLACE
SOUTHAMPTON, NJ 08088
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/18/2022 |
|
RITNER, ROBERT M. (RN)
252 PALISADE AVENUE, 3R
JERSEY CITY, NJ 07307
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/14/2024 |
|
RIVERA, DAISY (CHHA)
329 LINE STREET
CAMDEN, NJ 08103
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/29/2018 |
|
RIVERA, EMILIO JOSE (LPN)
536 1ST STREET, FLOOR 1
CARLSTADT, NJ 07072
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/13/2025 |
Permanent |
RIVERA, JACQUELINE (CHHA)
418 12TH STREET, APT. #1
UNION CITY, NJ 07087
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/23/2018 |
|
RIVERA, JOSSELIN
251 MT. VERNON ST.
CAMDEN, NJ 08103
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/27/2006 |
|
RIVERA, KAREN (CHHA)
209 NILES STREET, APT. 1
ELIZABETH, NJ 07202
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
RIVERA, MARIA (RN)
39 JOHNS WAY
BRIDGETON, NJ 08302
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/30/2019 |
|
RIVERA, NICOLE AKA CRESTA, NICOLE (RN)
2009 KICKAPOO TERRACE
VINELAND, NJ 08361
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/28/2017 |
3/24/2026 |
RIVERA, VIVIANIS (CHHA)
519 BRUNSWICK AVENUE
TRENTON, NJ 08638
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/20/2017 |
|
RIYAZ, FARHAAD (MD)
1145 19TH STREET NW, STE. 301
WASHINGTON, DC 20036
NPI-1063855286 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/15/2022 |
|
RIZK, MOHAMED (CHHA)
77 TWIN OAKS OVAL
SPRINGFIELD, NJ 07081
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/28/2023 |
|
RIZVI, SAIYID (PHD)
100 CRAIG ROAD, SUITE 104
MANALAPAN, NJ 07726
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/18/1997 |
|
RIZZO, KENNETH (RPH)
110 WELLS FARM ROAD
GOSHEN, NY 10924
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/19/2005 |
|
RIZZUTO, MARY F. (LCSW)
16 HOLLY DRIVE
TOMS RIVER, NJ 08753
NPI-1851499891 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/22/2012 |
|
ROBACK, MARY (LPN)
2517 DUNKSFERRY ROAD, APT. L203
BENSALEM, PA 19020
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/20/2018 |
|
ROBALINO, JOFFRE (MD)
PO BOX 1000
CUMBERLAND, MD 21501
NPI-1770634404 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/28/2013 |
|
ROBBERSON JR., KENNETH
3404 SHORELINE DRIVE
WALL TOWNSHIP, NJ 07719
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/16/2017 |
|
ROBBINS, GORDON J.
447 UNION AVENUE
PATERSON, NJ 07522
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/30/1987 |
Permanent |
ROBBINS, RICHARD G. (MD)
551 MILLBURN ACE.
SHORT HILLS, NJ 07078
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/19/2004 |
|
ROBERT, ELIANE (CHHA)
380 PARK AVENUE, APT. C5
ORANGE, NJ 07050
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/14/2017 |
|
ROBERTS, JAMES (RN)
235 PENN AVENUE
DOVER, NJ 07801
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/22/2017 |
|
ROBERTSON, TANAYE (CHHA)
1200 EAST STATE STREET, APT. 1405
CAMDEN, NJ 08105
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/10/2018 |
|
ROBINSON, CHRISTINA (CHHA)
81 ABBLETT VILLAGE
CAMDEN, NJ 08105
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/22/2019 |
|
ROBINSON, KIM
594 WALNUT STREET
ELIZABETH, NJ 07201
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
2/3/2003 |
|
ROBINSON, TRENNAJIA (CHHA)
89 FOURTH STREET, APT. #43
PASSAIC, NJ 07055
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2017 |
|
ROBINSON, VINCENT
62 MAPLE AVE.
IRVINGTON, NJ 07111
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
3/13/2009 |
3/13/2014 |
ROBINSON, WANDA
150 MELROSE AVE.
IRVINGTON, NJ 07111
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/4/1986 |
Permanent |
ROBLES, JOSEPH
500 E MAIN STREET, APT 230
TUCKERTON, NJ 08087
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
3/28/2024 |
9/16/2024 |
ROBLES, JOSEPH
500 E MAIN STREET, APT 230
TUCKERTON, NJ 08087
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/17/2024 |
|
RODENBERG, THOMAS (MD)
DESOTO ANNEX, 13617 SOUTHEAST HWY 70
ARCADIA, FL 34266
NPI-1720280183 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2015 |
|
RODRIGUEZ, ARACELY (CHHA)
1039 NORTH 35TH STREET
CAMDEN, NJ 08105
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/31/2018 |
|
RODRIGUEZ, BEATRIZ
109 GREENBRIAR AVE BOX157
RICHLAND, NJ 08350
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/18/2001 |
|
RODRIGUEZ, CHRISTIAN (CHHA)
2 W. PARK AVENUE
PENNS GROVE, NJ 08069
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/5/2019 |
|
RODRIGUEZ, DARIELI (CHHA)
545 NEWTON LAKE DRIVE
COLLINGSWOOD, NJ 08107
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/26/2017 |
|
RODRIGUEZ, FERNANDO (MD)
122 S. MONTFORT DRIVE
BELLE MEAD, NJ 08502
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/6/2004 |
|
RODRIGUEZ, JAZMIN (CHHA)
214 48TH STREET
UNION CITY, NJ 07087
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/10/2018 |
|
RODRIGUEZ, LEONELA (CHHA)
1032 N. 21ST STREET
CAMDEN, NJ 08105
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/10/2018 |
|
RODRIGUEZ, MELENYS (CHHA)
18 WINDING WOOD DRIVE
SAYREVILLE, NJ 08872
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/29/2017 |
|
RODRIGUEZ, NICOLE (CHHA)
658 DELSEA DRIVE
PITMAN, NJ 08071
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/6/2018 |
|
RODRIGUEZ, RAMON R.
100 MANHATTAN AVENUE
JERSEY CITY, NJ 07307
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/17/1986 |
DECEASED |
RODRIGUEZ, RONALD (LPN)
7 EASTERN LANE
WILLINGBORO, NJ 08046
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/20/2006 |
|
RODRIGUEZ, RONALD (LPN)
7 EASTERN LANE
WILLINGBORO, NJ 08046
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/11/2018 |
|
RODRIGUEZ, ROSEMARIE (CHHA)
1510 GROSS AVENUE
PENNSAUKEN, NJ 08110
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/20/2021 |
|
ROGERS, JAMES G.
49 WESTERN PARKWAY
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/11/2006 |
Permanent |
ROHAUS, ROBERT (LAB. EMPL)
301 LILAC COURT
BRIDGEWATER, NJ 08807
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
8/25/2000 |
|
ROHE, PAUL (DPM)
24 FAIRWAY DRIVE
GREEN BROOK, NJ 08812
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/20/2006 |
|
ROLON JR., ORLANDO
1239 DUPONT STREET
CAMDEN, NJ 08105
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/12/2009 |
|
ROMANAZZI, THOMAS
612 MYRTLE AVE
MANASQUAN, NJ 08786
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
ROMAN-CISSE, DENISE (PHARM TECH)
9 SECOND AVE
NEWARK, NJ 07104
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
4/12/2012 |
|
ROMANO, JOSEPH ANTHONY (RN)
13 SAWGRASS COURT
BLACKWOOD, NJ 08012
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/27/2025 |
|
ROMANOWSKI, NICCO
1263 PROMONTORY LANE
MARIETTA, GA 30062
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/11/2024 |
|
ROMANOWSKI, STEVEN
PO BOX 1011
UNION, NJ 07083
NPI- |
Medical
Poor Performance |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1985 |
Permanent |
ROMERO, IVAN (RPH)
USP CANAAN - PO BOX 300
WAYMART, PA 18472
NPI-1003089343 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/8/2011 |
|
ROMILLO, JOSE (MD)
954 FISCHER BOULEVARD
TOMS RIVER, NJ 08753
NPI-1467544155 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/16/2011 |
|
ROMITA, MAURO (MD)
6 JACKSON DRIVE
CRESSKILL, NJ 07626
NPI-1639243603 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/6/2024 |
|
RONAN, KATHLEEN (RN)
17 HENRY STREET
SAYERVILLE, NJ 08872
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/18/2001 |
|
RONCAL JR., MARIO
901 RIFLE CAMP ROAD
WOODLAND PARK, NJ 07424
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2014 |
|
RONDA JR., RAUL (LPN)
106 HILLSIDE AVENUE
ABSECON, NJ 08201
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2025 |
|
RONE, FELICIA (CHHA)
2702 SHETLAND WAY
WESTVILLE, NJ 08093
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/14/2017 |
|
ROQUE, JOSE RAMON (MD)
317 60TH STREET
W. NEW YORK, NJ 07903
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/1/1996 |
Permanent |
ROSA, EDDIE (MD)
796 MT. PROSPECT AVE
NEWARK, NJ 07104
NPI-1215045869 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
2/15/2012 |
|
ROSA, EDDIE (MD)
117-119 3RD AVE 2
NEWARK, NJ 07104
NPI-1215045869 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/26/2015 |
|
ROSA, EDDIE (MD)
796 MT. PROSPECT AVENUE
NEWARK, NJ 07104
NPI-1215045869 |
Medical
Antitrust/Anti-Kickback Acts |
Debarment Human Services
Medical Assistance (Medicaid) |
11/21/2016 |
|
ROSA, EDDIE (MD)
796 MT. PROSPECT AVENUE
NEWARK, NJ 07104
NPI-1215045869 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/17/2013 |
|
ROSADO, EDITH (CHHA)
326 GREGORY AVENUE
PASSAIC, NJ 07055
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
ROSANIA, NICHOLAS G. (DC)
1 COBBLESTONE LANE
LONG VALLEY, NJ 07853
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2003 |
|
ROSARIO, JASON (CHHA)
133 RUTGERS PLACE
NUTLEY, NJ 07110
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/1/2017 |
|
ROSE, RADCLIFFE (RN/PHARM TECH)
99 GROVE AVENUE
MAYWOOD, NJ 07607
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/21/2018 |
Permanent |
ROSEN, BURTON (DDS)
1939 ROUTE 70 EAST
CHERRY HILL, NJ 08003
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/24/1999 |
Permanent |
ROSEN, JAY
3 HIDDEN ACRES DRIVE
VOORHEES, NJ 08043
NPI-1720139736 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/22/2016 |
Permanent |
ROSENBERG, MARK (RN/APN)
19 BRANDYWINE DRIVE
MARLTON, NJ 08052
NPI-1407829096 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/21/2016 |
|
ROSENBLIT, ERIN (RN/APN)
654 8TH STREET
ABSECON, NJ 08201
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/5/2018 |
|
ROSENFARB, ANDREW (ACUPUNCTURIST)
332 SOUTH AVENUE EAST
WESTFIELD, NJ 07090
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/20/2005 |
|
ROSENSWEET, MARTIN (DPM)
FORT DIX FCI, PO 38
FORT DIX , NJ 08640
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/18/2002 |
|
ROSERO, BENITO (MD)
107 E. MANTUA AVENUE
WEHONAH, NJ 08090
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/2/1998 |
|
ROSERO, BENITO (MD)
109 AMBLER ROAD
CHERRY HILL, NJ 08002
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/6/1999 |
|
ROSS, BERNARD (MD)
30 E. PASSAIC STREET
MAYWOOD, NJ 07607
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/5/1999 |
Permanent |
ROSS, DOUGLAS AKA SHAW, RICKY
123 N 19TH STREET
EAST ORANGE, NJ 07017
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/14/2005 |
|
ROSS, JONATHAN (MD)
11 TEAK COURT
CHERRY HILL, NJ 08003
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/19/2000 |
Permanent |
ROSS, JOSIE B. (RN)
25 GRAND AVE.
HACKENSACK, NJ 07601
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/20/2004 |
|
ROSS, RUBY (LPN)
149 RIDGE AVENUE
ASBURY PARK, NJ 07712
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/5/2017 |
|
ROSSI, ANGELA (LPN)
813 HAZELTON AVENUE
LANOKA HARBOR, NJ 08734
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/5/2017 |
|
ROSSNICK, GERALD (DDS)
868 BROADWAY
BAYONNE, NJ 07002
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1988 |
Permanent |
ROTH, GERALD H. (DC)
325 CROWELLS ROAD, APT B
HIGHLAND PARK, NJ 08904
NPI-1255654208 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/4/2025 |
|
ROTHENBERG, HOWARD (DMD)
11 OAK SPRING ROAD
WEST NYACK, NY 10994
NPI-1437223898 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2017 |
|
ROTHSTEIN, JEFFREY (DMD)
326 BROAD STREET, SUITE 1
RED BANK, NJ 07701
NPI-1366677544 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2017 |
9/22/2017 |
ROTWEIN, PAUL S. (DDS)
220 E. 63RD ST, APT 8F
NEW YORK, NY 10021
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/20/2003 |
|
ROUNTSEV, ANATOLI AKA ROUNTSEZ, TONY (CHHA)
406 RIVERVIEW DRIVE
TOTOWA, NJ 07512
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/11/2016 |
|
ROUNTSEV, ANATOLI AKA ROUNTSEZ, TONY (CHHA)
409 RIVERVIEW DRIVE
TOTOWA, NJ 07512
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
11/4/2014 |
|
ROUNTSEZ, ANATOLI AKA ROUNTSEV, TONY (CHHA)
409 RIVERVIEW DRIVE
TOTOWA, NJ 07512
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
11/4/2014 |
|
ROUNTSEZ, ANATOLI AKA ROUNTSEV, TONY (CHHA)
406 RIVERVIEW DRIVE
TOTOWA, NJ 07512
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/11/2016 |
|
ROUSE, JODY (LPN)
189 BROWNIES RD.
SHIPPENVILLE, PA 16254
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
ROUSSIS, NICHOLAS (MD)
4735 HYLAN BOULEVARD
STATEN ISLAND, NY 10312
NPI-1497749089 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/1/2017 |
|
ROWE, ELIZABETH (LPN)
6 WINDING WOOD DRIVE, APT. 1B
SAYREVILLE, NJ 08872
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/28/2018 |
|
ROYALE, JAMES A. JR. (DC)
24 GULFSTREAM ROAD
NEW EGYPT, NJ 08533
NPI-1013921774 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/10/2026 |
|
ROYSTER, TAHNESHA (CHHA)
30 RIDGE AVENUE
NEPTUNE, NJ 07753
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/24/2017 |
|
ROZO, GLADYS
374B HAMILTON STREET
SOMERSET, NJ 08873
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/14/2007 |
|
ROZVAGA, NADEZHDA
155 ALEXAUKEN CREEK ROAD
LAMBERTVILLE, NJ 08530
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2009 |
|
RUANE, JOSEPH T. (DC)
314 WILLOW DRIVE
LITTLE SILVER, NJ 07739
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/8/1997 |
|
RUBBANI, MARIAM (LPN)
280 SOUTH HARRISON STREET
EAST ORANGE, NJ 07017
NPI-1801939723 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/12/2018 |
|
RUBINSTEIN, CHARLES (RPH)
45 LAUREL AVENUE
LINWOOD, NJ 08221
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2006 |
|
RUCHELMAN, TRINA (DDS)
2120 ROUTE 70
MANCHESTER, NJ 08759
NPI-1356425474 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2019 |
|
RUDOLPH, HERBERT (MD)
317 EAST MAIN STREET
TUCKERTON, NJ 08087
NPI-1871633370 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/14/2016 |
2/19/2020 |
RUFFIN, SHARALYN (CHHA)
OAKDALE VILLAGE TRAILER #52
CRANBURY, NJ 08512
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
RUGGIERO, PAULA E. (RN)
29 PARKWAY DRIVE
WESTVILLE, NJ 08093
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/18/2001 |
|
RUHREN, CHRISTINE (RN)
11 APPIO DRIVE
RANDOLPH, NJ 07869
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/25/2025 |
|
RUIZ, DORIS
909 WEST 7TH STREET
PLAINFIELD, NJ 07063
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/14/2007 |
|
RUIZ, JENNIFER
38 S. BRIDGEBORO STREET
DELRAN, NJ 08075
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/21/2016 |
|
RUIZ, LORRAINE (CHHA)
1131 N. 19TH STREET
CAMDEN, NJ 08105
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/5/2019 |
|
RULDAN, THOMAS (LPN)
301 OHIO AVENUE
PHILLIPSBURG, NJ 08865
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2001 |
|
RUMMA, CHRISTINE DONNA
164 STARBOARD STREET
FORKED RIVER, NJ 08731
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/26/2000 |
Permanent |
RUSH, DALE (LPN)
182 PRESTON ROAD, APT. H2
MILFORD, NJ 08848
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/11/2019 |
|
RUSH, DAVID A.
5755 PFEIFER CIRCLE
GERMANSVILLE, PA 18053
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
4/19/1999 |
Permanent |
RUSH, DAVID A.
5755 PFEIFER CIRCLE
GERMANSVILLE, PA 18053
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/11/2000 |
Permanent |
RUSHING, GARY (DC)
70 BROAD STREET, SUITE B
MATAWAN, NJ 07747
NPI-1538315478 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/20/2002 |
|
RUSSELL JR., BERTRAM R. (MD)
USP HAZELTON, BOX 2000
BRUCETON MILLS, WV 26525
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/28/2014 |
|
RUSSELL, FERNESE D. (CNA)
666 E. 26TH STREET
PATERSON, NJ 07504
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/24/2002 |
|
RUSSELL, ROBERT J. (DC)
1645 B-BLACKWOOD CLEMENTN
BLACKWOOD, NJ 08012
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/2/1995 |
Permanent |
RUSSO, GRACE (RN)
17 MAPLE PLACE
KEYPORT, NJ 07735
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/30/2019 |
|
RUSSOMANNO, RAYMOND (MD)
BLOOMFIELD AVENUE
BLOOMFIELD, NJ 07003
NPI-1093702532 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/28/2007 |
|
RUTA, EUGENIO (DC)
189 6TH AVENUE
LONG BRANCH, NJ 07740
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/21/2008 |
|
RUTHNASWAMY, ROMESH
1136 BLUEBIRD CIRCLE
MAYS LANDING, NJ 08330
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/18/2023 |
|
RUTIGLIANO, MICHAEL (MD)
1 SEARS DRIVE
PARAMUS, NJ 07652
NPI-1740348077 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/19/2016 |
|
RYAN, GERALDINE (RN)
228 RIDGE AVENUE
LAKEWOOD, NJ 08701
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/20/2002 |
|
RYAN, JAMES
267 SEACLIFF AVE
SEACLIFF, NY 11579
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/1/1996 |
4/1/2004 |
RYAN, MICHELE K. (LPN)
656 WHITE HORSE PIKE
HAMMONTON, NJ 08037
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/20/2002 |
|
RYBALOV, SEMEN
BERGEN COUNTY JAIL, PO BOX 0369
HACKENSACK, NJ 07601
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/28/2015 |
|
RYTEL, SYLVIA (LPN)
634 INDIANA AVENUE
TRENTON, NJ 08638
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/3/2019 |
|
SAADY, JACK R. (RPH)
281 ROUND HILL DRIVE
FREEHOLD, NJ 07728
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/11/2000 |
Permanent |
SABA-KHALIL, ROSALY (MD)
531 SUMMIT AVENUE
FRANKLIN LAKES, NJ 07417
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/10/1995 |
Permanent |
SABATE, NEONITA (RN)
PO BOX 4004
CLINTON, NJ 08809
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/27/2001 |
Permanent |
SABBAGHZADEH, ANDREW A.
108 BRANDON ROAD
EAST SYRACUSE, NY 13057
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
3/20/2012 |
|
SABIDO, BENJAMIN A. (MD)
805 11TH STREET
UNION CITY, NJ 07087
NPI-1720159916 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/26/2015 |
|
SACCA, COLLEEN (RN)
310 GARFIELD AVENUE
PALMYRA, NJ 08065
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2004 |
|
SACHER, PHILIP
558 ANDERSON AVE
CLIFFSIDE PARK, NJ 07010
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/6/1986 |
Permanent |
SADARANGANI, BHAGWAN (MD)
240 LYNCREST ROAD
ENGLEWOOD CLIFF, NJ 07632
NPI-1386790665 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/28/2011 |
|
SADLER, RUFUS (MD)
2 LAWRENCE STREET
MOUNT VERNON, NY 10552
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/3/2016 |
|
FINNEGANS PLAZA PHARMACY
11507 FINNEGANS LANE
NEW BRUNSWICK, NJ 08902SAEED,MOHAMMED
1507 FINNEGANS LANE
NEW BRUNSWICK, NJ 08902
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/16/1998 |
Permanent |
SAFIER, GARY (DO)
8 QUARRY COURT
RANDOLPH, NJ 07869
NPI-1558478529 |
Medical
Antitrust/Anti-Kickback Acts |
Debarment Human Services
Medical Assistance (Medicaid) |
4/1/2016 |
|
SAHNI, HARSHA R. (MD)
781 SYCAMORE AVENUE
RED BANK, NJ 07701
NPI-1467547232 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/5/2023 |
|
SAITOTI, FRANCIS (RN)
426 WHEELER ROAD
NORTH BRUNSWICK, NJ 08902
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/2025 |
|
SALAAM, ABDUL J. (MD)
1153 SOUTH ORANGE AVE
NEWARK, NJ 07103
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/7/1997 |
Permanent |
SALAGA, JENNIFER (RN)
248 WARD AVENUE
BORDENTOWN, NJ 08505
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/28/2017 |
|
SALAMI, ADEMOLA T.
HARVARD AVENUE
HILLSIDE, NJ 07205
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/15/2008 |
|
BETHEL PHARMACY
112 POND LANE
LINWOOD , NJ 08221SALARTASH, KHASHAYAR (MD)
112 POND LANE
LINWOOD, NJ 08221
NPI-1457376006 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
10/27/2009 |
10/7/2011 |
SALCEDO, CESAR E. (LPN)
31 LAMBERT STREET
WASHINGTON, NJ 07882
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/30/2023 |
|
SALEMA, JOSEPH
101 EAST ELM STREET
WENONAH, NJ 08090
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/4/1998 |
Permanent |
SALITA, CONRAD C. (MD)
1 N. VALLEY AVENUE
VINELAND, NJ 08360
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/1995 |
Permanent |
SALKIND, SCOTT A. (DO)
611 KINGS CROFT
CHERRY HILL, NJ 08034
NPI-1750401949 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/14/2000 |
|
SALOMONE, JOSEPH (DC)
53 COLLURA LANE 39
CLIFTON, NJ 07012
NPI-1609019140 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2015 |
|
SALUJA, DHANBIR (MD)
230 JEFFERSON STREET
NEWARK, NJ 07105
NPI-1023045010 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/24/2013 |
|
SALUJA, DHANBIR (MD)
230 JEFFERSON STREET, FL 1
NEWARK, NJ 07105
NPI-1023045010 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/3/2016 |
|
SALVATORE JR., THOMAS
201 HAMILTON AVE
TRENTON, NJ 08609
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
SAMAN, AIAD L.
47 CENTER PLACE
STATEN ISLAND, NY 10306
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/25/2009 |
|
SAMI, ASHRAF
64 CARUTH AVENUE, APT. 66
ELMWOOD PARK, NJ 07407
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/24/2017 |
|
SAMILLAN, HANS (CHHA)
3-3 SYDNEY WAY
LONG BRANCH, NJ 07740
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
SAMOOHI, SIAMAK
273 SETON HALL DRIVE
PARAMUS, NJ 07652
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/20/2024 |
|
SAMUEL, DELORIS AKA SOUFFRONT
P.O. BOX 4004
CLINTON, NJ 08809
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2008 |
|
SANCHEZ, MAURICE
243 PROSPECT AVENUE
NORTH ARLINGTON, NJ 07031
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/1/2011 |
4/30/2012 |
SANCHEZ, MELISSA (CHHA)
45 FRANKLIN PLACE
TOTOWA, NJ 07515
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/10/2018 |
|
SANDERLIN, KATHLEEN (RN)
824 SANIKAN TRAIL
SOUTHAMPTON, NJ 08088
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/18/2001 |
|
SANDERS, DENISE (PHARM TECH)
4 DREXEL COURT
SAYERVILLE, NJ 08021
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/12/1995 |
Permanent |
SANDERS, MICHAEL (THERAPIST)
4 CHERRY ROAD
NEWTOWN, NJ 07860
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/19/2006 |
|
SANDERSON, LYNN (LPN/RN)
120 GATES MILL COURT
TRENTON, NJ 08690
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2005 |
|
SANDHU, BALDEV (MD)
61 ASH STREET
ENGLEWOOD CLIFFS, NJ 07632
NPI-1255458105 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/12/2025 |
Permanent |
SANDHU, PARMINDERJEET S. (MD)
174 NAUGHRIGHT ROAD
LONG VALLEY, NJ 07853
NPI-1033298252 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/2022 |
|
SANDIEGO, NARDO (MD)
4 HEATHER HILL LANE
SUFFERN, NY 10901
NPI-1578508115 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/8/2013 |
|
SANFORD, CHRISTINE M.
227 BIRCH ROAD
TUCKERTON, NJ 08087
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2024 |
|
SANFORD, CHRISTINE M. (CNA)
1818 LINCOLN AVENUE, FL 2
ATLANTIC CITY, NJ 08401
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/10/2022 |
Permanent |
SANGALANG, ALEX (RN)
21 LISA DRIVE
HAZLET, NJ 07730
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/5/2017 |
|
SANGAVARAM, KRISTAPPA (MD)
6 BERKSHIRE PLACE
ENGLEWOOD CLIFFS, NJ 07632
NPI-1376635722 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/28/2021 |
|
SANGAVARAM, KRISTAPPA (MD)
6 BERKSHIRE PLACE
ENGLEWOOD CLIFFS, NJ 07632
NPI-1376635722 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/19/2023 |
|
SANGHERA, ANIL
105 PHEASANT FIELD LANE
MOORESTOWN, NJ 08057
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2009 |
|
SANICO, ELAINE D. (DPM)
122 BRIGHT ST., #1W
JERSEY CITY, NJ 07302
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/19/1997 |
|
SANKIN, GENE (MD)
82 ADMIRALTY LOOP
STATEN ISLAND, NY 10309
NPI-1992971469 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/11/2021 |
|
SANTA MARIA, DONNA L. (RN)
618 CINDER ROAD
EDISON, NJ 08820
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/18/2001 |
Permanent |
SANTANA, SONIA (CHHA)
569 E. 33RD STREET
PATERSON, NJ 07613
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/28/2001 |
Permanent |
SANTANGELO, FRANK (MD)
705 HAMBURG TURNPIKE
WAYNE, NJ 07470
NPI-1881785293 |
Medical
Antitrust/Anti-Kickback Acts |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/22/2016 |
|
SANTANGELO, FRANK (MD)
FCI-FORT DIX, PO BOX 2000
JOINT BASE MDL, NJ 08640
NPI-1881785293 |
Medical
Antitrust/Anti-Kickback Acts |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/13/2017 |
|
SANTANIELLO, RICHARD J.
5 BUGLE COURT
HOWELL, NJ 07731
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/20/2002 |
|
SANTIAGO JR., EDDIE (MD)
300 SECOND AVENUE
LONG BRANCH, NJ 07740
NPI-1497796973 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/1/2014 |
8/22/2019 |
SANTIAGO, HEDBERTO (CNA)
3265 S. US HIGHWAY 1, LOT 6
FORT PIERCE, FL 34982
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/12/2020 |
|
SANTIAGO, RANALDO
GIBBSBORO RD.
LINDENWOLD, NJ 08021
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/10/2007 |
Permanent |
SANTIAGO, REYNALDO (MD)
1502A MARCY PLACE
PHILADELPHIA, PA 19115
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/16/1997 |
Permanent |
SANTIAGO, RUTH M. (CHHA)
289 BROADWAY, APT. E
NEWARK, NJ 07104
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/19/2001 |
|
SANTIAGO, VANESSA
35 AMHERST ROAD
SOUTH TOMS RIVE, NJ 08757
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/31/2006 |
|
SANTIAGO-JIMINEZ, HERIBERTO
396 WOODLAND AVENUE
SOUTH AMBOY, NJ 08879
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/19/2011 |
|
SANTOS - ARIAS, SIMON (MD)
10305 NW 7TH COURT
PLANTATION, FL 33324
NPI-1497721062 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/18/2016 |
|
SANTOS DE DECENA, SONIA M. (CHHA)
318 LAFAYETTE AVENUE
PASSAIC, NJ 07055
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/25/2023 |
|
SANTOS, MARIA HAZEL P. aka DAVENPORT, MARIA HAZEL P. (CHHA)
7 LAIDLAW AVENUE
JERSEY CITY, NJ 07306
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/25/2023 |
|
SAPERSTEIN, ALAN
30 HIGHLAND RD-DIX HILLS
LONG ISLAND, NY 11746
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/1/1987 |
Permanent |
SARKODIE, ALEX (MD)
516 YORKTOWN ROAD
UNION , NJ 07083
NPI-1598870271 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/14/2016 |
|
SARKODIE, ALEX (MD)
516 YORKTOWN ROAD
UNION, NJ 07083
NPI-1598870271 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/5/2017 |
|
SARVAIYA, RAMESH (MD)
26 EASTWOOD DRIVE
VOORHEES, NJ 08043
NPI-1578558748 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/14/2021 |
|
SATCHER, WILLIAM
558 ANDERSON AVENUE
CLIFFSIDE PARK, NJ 07010
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
SAUCHELLI, FRANCIS (MD)
151 BLOOMFIELD AVENUE, APT. 502
VERONA, NJ 07044
NPI-1124586326 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/13/2019 |
|
SAUL, STEPHEN L. (DPM)
9 SEASIDE COURT
MARGATE CITY, NJ 08402
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/12/2016 |
Permanent |
SAUL, STEPHEN L. (DPM)
76 W. JIMMIE LEEDS ROAD
ABSECON, NJ 08201
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/18/2001 |
Permanent |
SAVINO, THOMAS (MD)
65 BUTTONWOOD ROAD
STATEN ISLAND, NY 10304
NPI-1821087305 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/10/2018 |
|
SAVINO, THOMAS (MD)
FCI FORT DIX, PO BOX 2000
JOINT BASE MDL, NJ 08640
NPI-1821087305 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/18/2019 |
|
SAYED, SAQUIB (MD)
4 TURTLE HOLLOW COURT
SICKLERVILLE, NJ 08051
NPI-1609054360 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/29/2016 |
|
SAYED-BAKHATY, ABDEL (MD)
403 HARMON TOWERS
SECAUCUS, NJ 07094
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
4/26/1995 |
|
SAYEGH, RICKY (MD)
4 FOWLER AVENUE
YONKERS, NY 10701
NPI-1346274966 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/19/2016 |
|
SAYEGH, RICKY (MD)
390 FORT HILL ROAD
SCARSDALE, NY 10583
NPI-1346274966 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
11/20/2017 |
|
SBARRA, SAMUEL
PARK AVENUE
NUTLEY, NJ 07110
NPI-1205913100 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2008 |
1/20/2015 |
SCARPITTA, JANET
92 PEABODY PLACE
NEWARK`, NJ 07104
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/15/2001 |
Permanent |
SCERBO, ERNEST J. (MD)
26 01 BROADWAY SUITE 103
FAIR LAWN, NJ 07410
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
DECEASED |
SCHECHTER, MARVIN (OD)
100 YORKTOWN DR
MT LAUREL, NJ 08054
NPI-1063420453 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
SCHEIN, HERBERT W. (MD)
1027 HOOPER AVENUE
TOMS RIVER, NJ 08753
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/30/1991 |
DECEASED |
SCHEINBAUM, CHAIM
24 ROOSEVELT AVENUE
LAKEWOOD, NJ 08701
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/3/2024 |
|
SCHEINER, DAVE E. (DPM)
910 BONAPARTE COURT
PHILADELPHIA, PA 19107
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/22/1999 |
|
SCHENKEL, CATHERINE (RN)
87 IRVING AVENUE APT. 3
LIVINGSTON, NJ 07039
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/20/2009 |
|
SCHENKEL, CATHERINE (RN)
87 IRVING AVENUE APT. 3
LIVINGSTON, NJ 07039
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
5/30/2010 |
|
SCHLACHTER, ANDREA
42 WEST HOLLY STREET
CRANFORD, NJ 07016
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/20/2006 |
|
SCHLEIDER, ALEXANDER
299 ALBERT AVENUE
LAKEWOOD, NJ 08701
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/26/2023 |
|
SCHLEMBACH, ANDREA AKA OLIVER, ANDREA (APN/RN)
70 COHANSEY STREET
BRIDGETON, NJ 08302
NPI-1780630418 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/12/2016 |
5/21/2020 |
SCHLISSERMAN, HERMAN
300 48TH STREET
UNION CITY, NJ 07087
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
SCHMIDT, KIMBERLY
47 MONARCH COURT
STATEN ISLAND, NY 10314
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/5/2024 |
|
SCHMIDT, NORINE (RN)
78 S. ROOSEVELT SQUARE
ENGLEWOOD, NJ 07631
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/12/2018 |
|
SCHMOLK, DERICK (RN)
11 BEVIS LANE
CAPE MAY COURT HOUSE, NJ 08210
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/25/2019 |
|
SCHMUCKER-KARPOW, CELESTE (MD)
50 MAPLE AVENUE
MORRISTOWN, NJ 07960
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/27/1995 |
DECEASED |
SCHNEIDER, BRUCE J. (DDS)
520 CLIFFORD AVENUE, E8
MATAWAN, NJ 07747
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/20/2006 |
|
SCHNEIDER, WAYNE R. (MD)
56 TUCKAHOE ROAD
MARMORA, NJ 08223
NPI-1619916244 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/30/2024 |
|
SCHNEIDERMAN, ROBERT
843 PERSIMMON LANE
LANGHORNE, PA 19047
NPI- |
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/4/2024 |
|
SCHOBERT III, WILLIAM B.
25 WELLINGTON DRIVE, #D
LUMBERTON, NJ 08048
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/20/2009 |
7/14/2014 |
SCHRAGER, KENNETH J. (MD)
FCI - OTISVILLE, PO BOX 600
OTISVILLE, NY 10963
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/19/2001 |
|
SCHROEDER, PETER (RN)
18 PILGRIM WAY
HAMILTON, NJ 08620
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/11/2017 |
|
SCHULTZ, STEVEN (MD)
1495 EAST 92ND STREET #2
BROOKLYN, NY 11236
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/9/1999 |
Permanent |
SCHUTT, CHARLES HARDEN
21 PARMLEY ROAD
TINTON FALLS, NJ 07724
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/8/1978 |
Permanent |
INDUS. PRESCR. SVCS. INC.
60 SIP AVENUE
JERSEY CITY, NJ 07306SCHWARTZ, EDWARD R. (RPH)
60 SIP AVENUE
JERSEY CITY, NJ 07306
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/6/1998 |
RETIRED |
SCHWARTZ, EDWARD R. (RPH)
720 HARMON COVE TOWERS
SECAUCUS, NJ 07094
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/17/2001 |
RETIRED |
SCHWARTZ, EDWARD R. (RPH)
1021 HERALD STREET
REDLANDS, CA 92374
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/20/2000 |
RETIRED |
SCHWARTZ, GEORGE ROBERT
PO BOX 1806
SANTA FE, NM 87504
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/19/2007 |
|
SCHWARTZ, JADE (LPN)
97 SHORELAND CIRCLE
SOUTH AMBOY, NJ 08879
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/21/2018 |
|
SCHWARTZ, JOSEPH
1859 54TH STREET
BROOKLYN, NY 11204
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
2/8/2022 |
7/28/2025 |
SCHWARTZ, JOSEPH
1859 54TH STREET
BROOKLYN, NY 11204
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/29/2025 |
|
SCHWARTZ, LOUIS
30 SCENIC DRIVE
SUFFERN, NY 10901
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/3/2024 |
7/2/2025 |
SCHWARTZ, LOUIS
30 SCENIC DRIVE
SUFFERN, NY 10901
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/3/2025 |
|
SCHWARTZ, MARK L. (MD)
308 CHELSEA MANOR
PARK RIDGE, NJ 07656
NPI-1164436325 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/16/2018 |
|
SCHWARTZ, MURRAY (DO)
5 AUTUMN COURT
CHERRY HILL, NJ 08003
NPI-1063573012 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/23/2013 |
|
SCHWARTZ, MURRAY (DO)
5 AUTUMN COURT
CHERRY HILL, NJ 08003
NPI-1063573012 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
12/5/2013 |
|
SCHWARZ, DENISE (DPM)
1729 PAMMEL PARK ROAD
WINTERSET, IA 50273
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/20/2002 |
|
SCOPELLITI, ALDO R. (DC)
107 MONMOUTH ROAD
W. LONG BRANCH, NJ 07764
NPI-1568524049 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/12/2000 |
|
SCOTT, DEBRA
2751 S. OCEAN DRIVE
HOLLYWOOD, FL 33019
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2004 |
|
SCOTT, GLENN (RN)
70 POLIFLY RD. APT. 105
HACKENSACK, NJ 07601
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/18/2001 |
|
SCOTT, MARVELL (MD)
41 FIDDLERS WAY
SPARTA, NJ 07871
NPI-1144417478 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/12/2020 |
|
SCOTT, MCKENZIE (LPN)
457 REDBANK ROAD
TEMPLETON, PA 16259
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
SCOTT, MELVIN
42 HIGHLAND TERRACE
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/3/2001 |
|
SCULLION, FRANCES (RN)
20 BREAKNECK ROAD
OAKLAND, NJ 07436
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/13/1988 |
Permanent |
SCURRY, MARSHAYA (PHARM TECH)
1500 GARDEN DRIVE
OCEAN, NJ 07712
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/4/2017 |
6/26/2018 |
SEAMAN, VIVIAN (RN)
823 TENTH STREET
UNION BEACH, NJ 07735
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/12/2016 |
|
SEDEHI, AHMAD (DMD)
31 JANE DRIVE
ENGLEWOOD CLIFFS, NJ 07632
NPI-1063634640 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/1/2017 |
|
SEGLIN, MARK (PSYCH)
89 LAPIS CIRCLE
WEST ORANGE, NJ 07052
NPI-1184754632 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/1/2017 |
|
SEHGAL, GAUTAM (MD)
8 WINDERMERE COURT
LIVINGSTON, NJ 07039
NPI-1497801740 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/2/2016 |
|
SEHGAL, SHASHIBALA (MD)
630 FT. WASHINGTON AVENUE
NEW YORK, NY 10040
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/31/2000 |
10/17/2018 |
SEIFERT, APRIL ANN a.k.a. APRIL PRONIEWSKI (APN/RN)
9 SIOUX ROAD
PENNINGTON, NJ 08534
NPI-1710390471 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/18/2024 |
|
HANAN PHARMACY, INC.
47 NORWOOD AVENUE
CLIFTON, NJ 07011SELIM, HANAN (RPH)
47 NORWOOD AVENUE
CLIFTON, NJ 07011
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
5/30/2000 |
|
22225902200
PATIENT COACH MED TRANSP
724 GROVE ST
IRVINGTON, NJ 07111SEMPLE, IVRY
724 GROVE ST
IRVINGTON, NJ 07111
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/24/1985 |
Permanent |
SEMPLE, IVRY
472 LAKESIDE AVE.
ORANGE, NJ 07050
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/14/1986 |
Permanent |
SENAPE, SAVERIO (MD)
215 WEST 92ND STREET 15A
NEW YORK, NY 10025
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/5/1998 |
Permanent |
SENATORE, SALVATORE (DC)
342 LINCOLN DRIVE
KENILWORTH, NJ 07033
NPI-1073653366 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/19/2010 |
|
SENDER, PAUL (MD)
30A WEST MAPLE AVENUE
MONSEY, NY 10952
NPI-1124321286 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/20/2006 |
12/22/2014 |
SENQUIZ, LUZ (COUNSELOR)
471 HIGHLAND AVE., APT.A
COLLINGSWOOD, NJ 08108
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
4/29/2003 |
|
SENTILLES, JEAN (MD)
150 W 56TH ST NO 509
NEW YORK, NY 10019
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/27/1992 |
Permanent |
SEPAHBODY, CYRUS (DDS)
507 SUMMERFIELD AVENUE, APT. 2
ASBURY PARK, NJ 07712
NPI-1487706305 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/18/2019 |
5/31/2023 |
SERENO, PATRICIA (RN/LPN)
18 SECRETARIAT STREET
HOWELL, NJ 07731
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2001 |
|
SERPE, JOSEPH (RN)
459 MAIN STREET
STATEN ISLAND, NY 10307
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/5/2017 |
|
SERRANO, KRISTINA (CHHA)
59 ARCADIA PLACE, #B
VINELAND, NJ 08360
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
SESAY, CHERYL (LPN)
12 AVA AVENUE
SOMERDALE, NJ 08083
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2002 |
|
SESSOMS, VALERIE
29 STRATFORD PLACE,APT 6J
NEWARK, NJ 07108
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2012 |
|
SEUFERT, ANNA MARIE (CHHA)
5139 LAKE WORTH ROAD
GREEN ACRES, FL 33463
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/19/2014 |
|
SEVUMYANTS, RUBEN
3 BRETON COURT
MARLBORO, NJ 07746
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/6/2024 |
|
SEXTON, JILL (RN)
5460 ROUTE 100
PLYMOUTH, VT 05056
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/12/2016 |
|
SHACK, DANIEL (RPH)
2 GRACEHILL COURT, APT.
TITUSVILLE, NJ 08560
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2006 |
|
SHAH, JAYEN C. (MD)
MEADOWLANDS PARKWAY
SECAUCUS, NJ 07096
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/26/1996 |
Permanent |
SHAH, SATISH (MD)
401 CLARKSTOWN ROAD
MAYS LANDING, NJ 08330
NPI-1730129826 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/1/2024 |
Permanent |
SHAHINE, AYMAN (MD)
334 86TH STREET
BROOKLYN, NY 10024
NPI-1235341850 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/1/2019 |
|
SHAKARJIAN, CARNIG C. (DPM)
MEADOWLANDS PARKWAY
EMERSON, NJ 07630
NPI-1720007743 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/25/2013 |
|
SHARIF, MUDASSAR (MD)
308 MOUNTAIN ROAD
BASKING RIDGE, NJ 07920
NPI-1366509903 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/16/2015 |
|
SHARIM, IRADJ (MD)
1208 BIRCH AVENUE
YARDLEY, PA 19067
NPI-1790739423/1588610851 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/14/2020 |
Permanent |
SHARMA, RAVINDER (MD)
3 MARTIN COURT
MARTINSVILLE, NJ 08836
NPI-1306947999 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/22/2016 |
1/3/2019 |
ADVANCED OPTICAL CENTER
168 HAMILTON AVENUE
TRENTON, NJ 08609SHARMA, YOGENDRA P. (OD)
17 VAHLSING WAY
ROBBINSVILLE, NJ 08691
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/28/2000 |
Permanent |
SHAROW, RALPH (DMD)
PO BOX 1000- CAMP
FORT DIX, NJ 08640
NPI-1679670038 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/20/2003 |
|
SHAW, RICKY AKA ROSS, DOUGLAS
123 N 19TH STREET
EAST ORANGE, NJ 07017
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/14/2005 |
|
SHEA, ANN M. (RN)
706-08 ZLOTKIN CIRCLE
FREEHOLD, NJ 07728
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/18/2001 |
|
SHEIKH, IMTIAZ A. (MD)
1008 BRAINARD PLACE
BRIELLE, NJ 08730
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
SHEIKH, MOHAMMAD
59-07 71ST AVENUE
RIDGEWOOD, NY 11385
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/20/2003 |
|
SHEIKH, NAFEESA
516 BLOOMFIELD AVE.
NUTLEY, NJ 07110
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/20/2003 |
|
SHELCHKOV, DMITRY A. ANATOLEVICH (MD)
3000 BRIGHTON 12TH STREET, APT A9
BROOKLYN, NY 11235
NPI-1023128402 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/2023 |
|
SHER, JOHN
8097 FULTON AVENUE
MARGATE CITY, NJ 08402
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/28/2023 |
|
SHER, JOHN
P.O. BOX 1000
LEWISBURG, PA 17837
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/20/2023 |
|
SHER, THOMAS
224 ROOSEVELT AVENUE
NORTHFIELD, NJ 08225
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/25/2023 |
|
SHER, THOMAS
P.O. BOX 2000
JOINT BASE MDL, NJ 08640
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/20/2023 |
|
SHERANI, TAHIR S.
215 N. WYOMING STREET
S. ORANGE, NJ 07079
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/7/2000 |
Permanent |
SHERMAN, HENRY M. (MD)
141 S. HARRISON STREET
EAST ORANGE, NJ 07018
NPI-1922334457 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/5/1997 |
12/14/2011 |
SHIELDS, HEATHER (LPN)
100 ROLLING ACRES
SLIPPERY ROCK, PA 16057
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
SHIPMAN, BRYAN LEE
1210 CHERSONESE ROUND
MOUNT PLEASANT, SC 29464
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/2012 |
|
SHKLOVER, TOBIAS (MD)
2611 W. 2ND STREET
BROOKLYN, NY 11223
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2007 |
|
SHMIDMAN-HOROWITZ, MIRIAM
8215 ABINGTON ROAD
KEW GARDENS, NY 11478
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
SHONUBI, RASHIDAT A. (CHHA)
9 BLOOM STREET, FLOOR 2
NEWARK, NJ 07103
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/28/2024 |
|
SHRAMOWIAT, MICHAEL (MD)
1158 46TH STREET, APT. A
VIENNA, WV 26105
NPI-1568485233 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/14/2021 |
|
SHROPE, CATHY, L.
175 COUNTY ROUTE 519 S.
BELVIDERE, NJ 07823
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/22/2002 |
|
SHROUT, WILLIAM
PO BOX 280
FAIRTON, NJ 08320
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2001 |
|
SHTINDLER, EDUARD
150 CUMBERLAND COURT
PARAMUS, NJ 07093
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
9/30/2019 |
|
SHTINDLER, YANA
3 NORGATE ROAD
GLEN HEAD, NY 11545
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/11/2024 |
|
SHULMAN, JONATHAN (RN)
11945 NE 19TH DRIVE, APT. 1
NORTH MIAMI, FL 33181
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/18/2019 |
|
SHUSTER, LARRY B. (RPH)
3136 GUILFORD STREET
PHILADELPHIA, PA 19152
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/9/2008 |
6/26/2017 |
SIAM, NABIL A.
67 HIGHWAY 37, PO BOX 193
TOMS RIVER, NJ 08754
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/1/1999 |
Permanent |
SIBERT, SCOTT L. (MD)
43 WOODLAND AVENUE
WOODBURY, NJ 08096
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/15/1985 |
DECEASED |
SIDDIQUI, AFTAB A. (MD)
504 LIVINGSTON STREET
NORWOOD, NJ 07648
NPI-1073527545 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/19/1998 |
|
SIDDIQUI, NURUL HASAN
4912 BERGENLINE AVENUE
WEST NEW YORK, NJ 07093
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/12/1996 |
Permanent |
SIDDIQUI, SHAKIR H.
619 SCHUYLER AVENUE
KEARNEY, NJ 07032
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/10/1998 |
|
SIDDIQUI, SHOAIB H.
9 TOWER DRIVE
EAST HANOVER, NJ 07936
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/19/2001 |
|
SIEGEL, JONATHAN B. (DPM)
4772 HIGHWAY 9 SOUTH
HOWELL, NJ 07731
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/11/2000 |
Permanent |
SIGLE, EDWARD
CRANBURY SOUTH RIVER ROAD
MONROE TWP., NJ 08831
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/29/2007 |
Permanent |
SILK, EMILY ANN (RN)
250 N PEARL STREET, APT 306
DENVER, CO 80203
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/19/2023 |
7/26/2024 |
SILMAN, ALEXANDER (DDS)
3 CLARK PLACE
MARLBORO, NJ 07746
NPI-1629319751 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/22/2010 |
1/5/2018 |
SILVA, SANDY (COUNSELOR)
2208 HILLCREST AVENUE
PENNSAUKEN, NJ 08110
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
4/29/2003 |
|
SILVERHARDT, STEPHEN (DDS)
1436 MARSHALL LANE
MEADOWBROOK, PA 19046
NPI-1881821403 |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/16/1988 |
10/28/2022 |
SILVERMAN, HAROLD
529 BROAD STREET
NEWARK, NJ 07102
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
SIMMONETTI, A'DAYJA AKA SIMONETH, A'DAYJA (CHHA)
711 CEDAR STREET
LAKEHURST, NJ 08733
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/18/2017 |
|
SIMMONS, SHAMEKIA
RIDGE AVENUE
ASBURY PARK, NJ 07712
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/21/2008 |
|
SIMONE, RENEE CRIVELLO (RPH)
403 SCOTT COURT
UNION, NJ 07083
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/22/2010 |
|
SIMONETH, A'DAYJA AKA SIMMONETTI, A'DAYJA (CHHA)
711 CEDAR STREET
LAKEHURST, NJ 08733
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/18/2017 |
|
SINGER, LYNN F. (DC)
12-17 EDWARD STREET, APT 17
FAIR LAWN, NJ 07410
NPI-1528242690 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/12/2025 |
|
SINGH, MANJIT (MD)
12 HARRISON MOUNT LAKE RD
RINGWOOD, NJ 07456
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/24/2007 |
|
SINGH, MANJIT (MD)
21 LEHMAN STREET
MAHWAH, NJ 07430
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/24/1998 |
|
SINGH, PARAMJIT J. (MD)
5919 STUMPH ROAD, UNIT 4
CLEVELAND, OH 44130
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/2022 |
|
SINGH, PRITPAUL (MD)
9 KIMBERLY COURT
VOORHEES, NJ 08043
NPI-1164717807 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/27/2021 |
Permanent |
SINGH, SAGGOO (MD)
485 S. DOBSON RD, STE 202
CHANDLER, AZ 85224
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/20/1995 |
|
SINGH, SURINDER (MD)
288 SUMMIT AVENUE
JERSEY CITY, NJ 07306
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/23/2007 |
Permanent |
SINGLETARY, GWENDOLYN
18 EAST AVENUE
BRIDGETON, NJ 08302
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/25/2025 |
|
SINGLETON, RUSSELL (DMD)
401 BROADWAY
CAMDEN, NJ 08103
NPI-1912166133 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/9/2014 |
1/10/2018 |
SINGLETON, WANDRA (LPN)
86 MELROSE AVENUE
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/5/2017 |
|
SINHA, BINOD (MD)
3 HELENE AVENUE
EDISON, NJ 08820
NPI-1932201662 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/3/2017 |
Permanent |
SINHA, BINOD (MD)
3 HELENE AVENUE
EDISON, NJ 08820
NPI-1932201662 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/6/2017 |
Permanent |
SINVANY-NUBEL, AVIVA (RN/APN)
683 DONALD DRIVE NORTH
BRIDGEWATER, NJ 08807
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2005 |
|
SIRIPURAPU, PADMA (MD)
201 LYONS AVENUE
NEWARK, NJ 07112
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
2/15/2012 |
12/3/2020 |
SIRIPURAPU, PADMA (MD)
1 SCENIC HILLS COURT
BELLE MEAD, NJ 08502
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/30/2014 |
12/3/2020 |
SIROTA, ALEKSANDR
PO BOX 2000
LEWISBURG, PA 17837
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/19/2010 |
|
SISON, JOSEPH (MD)
41 BROWNSTON WAY STE 218
ENGLEWOOD, NJ 07631
NPI-1730110149 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/2/2011 |
|
SIVAKANTHA, SIVAGNANALIN (PSYCH)
P.O. BOX 5503
SOMERSET, NJ 08875
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2011 |
|
SKAGGS, MATTHEW A.
2127 QUAETHEM DRIVE
CHESTERFIELD, MO 63005
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/20/2012 |
|
SKORUPSKI, THOMAS (DO)
3 WELSH DRIVE
FLORHAM PARK, NJ 07932
NPI-1033163167 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/27/2022 |
|
SKURATON, JEFFREY (RPH)
WINGED FOOT DRIVE
LIVINGSTON, NJ 07039
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/19/2008 |
|
SLAKIE, CHRISTINE (RN)
103 EDGE LANE
WILLINGBORO, NJ 08046
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2003 |
|
SLATER, BARBARA A. (LPN)
7 POINT ROAD
TOMS RIVER, NJ 08753
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/18/2001 |
|
SLOAN, BARRY (DO)
P.O. BOX 1186
MORAVIA, NY 13118
NPI-1770578262 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2022 |
|
SLOAN, BARRY (MD)
1561 LEMOINE AVENUE
FORT LEE, NJ 07024
NPI-1770578262 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/31/2018 |
|
SLOAN, DEBRA
31 SCHAAF ROAD
BLOOMSBURY, NJ 08804
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
8/12/2012 |
|
SLOTNICK, SINO
1556 RIVER ROAD
TEANECK, NJ 07666
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
SLOVER, SHAYLA
NORTH MAPLE AVE.
MARLTON, NJ 08053
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/4/2007 |
Permanent |
SMITH III, RUSSELL (LPN)
33 ORCHARD AVENUE
PENNINGTON, NJ 08534
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/19/2007 |
|
SMITH III, RUSSELL P. (LPN)
714 S. PENNSYLVANIA AVENUE
MORRISVILLE, PA 19067
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/22/2007 |
|
SMITH, ALPHONSO (MD)
421 WESTWOOD DRIVE #U
WOODBURY, NJ 08096
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/31/2002 |
|
SMITH, CHARLES
1825 67TH AVENUE
PHILADELPHIA, PA 19126
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
SMITH, DAVID J. (MD)
8930 W. SUNSET ROAD, SUITE 350
LAS VEGAS, NV 89148
NPI-1811930357 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/4/2023 |
|
SMITH, DWAYNE
12-14 ELM STREET APT 6
MONTCLAIR, NJ 07042
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/23/2007 |
|
SMITH, JENNIFER LYNN
428 GLENWOOD AVENUE
WILLIAMSPORT, PA 17701
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
SMITH, JOHANNA (LPN/RN)
1507 ATLANTIC AVENUE, APT. 65
MANASQUAN, NJ 08736
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/27/2018 |
11/10/2023 |
SMITH, KHALILAH (LPN)
32 ELIZABETH STREET
HACKENSACK, NJ 07601
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/27/2018 |
|
SMITH, LAKESIA (CHHA)
2030 RIVERSIDE DRIVE, APT. 10B
TRENTON, NJ 08618
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
SMITH, LARRY
183 SOUTH HIGHLAND AVENUE, APT. 1
YORK, PA 17404
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
SMITH, LAURA (LPN)
OLD FREEHOLD ROAD
TOMS RIVER, NJ 08753
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/18/2007 |
|
SMITH, LORRAINE A. (CHHA)
99 HOLSMAN STREET
PATERSON, NJ 07522
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/12/2025 |
|
SMITH, MARK (RPH)
1510 OCEAN PARKWAY, #18F
BROOKLYN, NY 11230
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/28/2017 |
|
SMITH, TAMMY (CHHA)
203 LAKEVIEW BOULEVARD
BROWNS MILLS, NJ 08015
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
SMITH, WILLIAM
RT 1 35 WHITE TAIL ROAD
SAN MARCOS, TX 78666
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
SMITH-DORSEY, JULIA (RN)
37 WINFIELD DRIVE
PARSIPPANY, NJ 07054
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/2/2017 |
8/22/2019 |
SMITH-RENSHAW, AISLING (RN)
25 EAST FOREST GLEN DRIVE
MILLVILLE, NJ 08332
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2022 |
|
SMOLEV, JOSEPH M. (MD)
158 HAMILTON AVE
PASSAIC, NJ 07055
NPI- |
Medical
Poor Performance |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
SMOLIN, STEVE (RPH)
228 KINGS HIGHWAY
BROOKLYN, NY 11223
NPI-1124184619 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/7/2001 |
Permanent |
SMUTEK, MICHELLE M. (LPN)
2115 FLORENCE AVENUE
HAZLET, NJ 07735
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/20/2002 |
|
SNELL, PHILIP (MD)
217 PAULISON AVENUE
PASSAIC, NJ 07055
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
SODANO, MICHAEL
708 FOREPEAK AVE
BEACHWOOD, NJ 08722
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
SODANO, MICHAEL J.
708 FOREPEAK AVENUE
BEACHWOOD, NJ 08722
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/6/1999 |
|
SOHN, YOUNG (PSYCH)
63 CARLOUGH ROAD
U. SADDLE RIVER, NJ 07458
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2000 |
|
SOKALSKY, BRIAN (DO)
11 BAYCREST DRIVE
MARGATE CITY, NJ 08402
NPI-1881872828 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/11/2023 |
|
SOKHA, BORIS
FCI FORT DIX
FORT DIX, NJ 08640
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2009 |
|
SOLARZ, LAUREN
1133 THACKERY CIRCLE
VOORHEES, NJ 08043
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/19/1999 |
|
SOLBERG, BYRNE (MD)
103 FOXHALL LANE
NARBERT, PA 19072
NPI-1710996871 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
SOLBERG, BYRNE (MD)
107 PENN STREET
RIVERTON, NJ 08077
NPI-1710996871 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/21/2018 |
|
SOLIMANDO, LISA (LPN)
41 LONG VALLEY ROAD
LODI, NJ 07644
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/28/2017 |
9/23/2022 |
SOLOMON, JENNIFER
142 BROAD STREET
NEWARK, NJ 07104
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/25/2002 |
|
SOLOMON'S INVALID COACH
142 BROAD STREET
NEWARK, NJ 07104SOLOMON, MARCUS
142 BROAD STRET
NEWARK, NJ 07104
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/25/2002 |
|
SOLOMONOV, MIKHAIL (MD)
9 HAMILTON DRIVE SOUTH
NORTH CALDWELL, NJ 07006
NPI-1225095672 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/17/2019 |
|
SOMERSET, WILLARD F. (RPH)
1123 BROAD ST
NEWARK, NJ 07114
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/1/1988 |
Permanent |
SONG, KI I. (MD)
62 COTTAGE STREET
JERSEY CITY, NJ 07306
NPI-1720138936 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/7/2011 |
Permanent |
SONG, YO-JUN (MD)
1857 DIAMOND HEAD DRIVE
CASTLE ROCK, CO 80104
NPI-1982657540 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/28/2017 |
Permanent |
SONG, YOUNG
37 DEANNA DRIVE
EAST HANOVER, NJ 07936
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/2010 |
7/19/2015 |
SONI, HARDIK (MD)
90 BEAUVOIR AVENUE
SUMMIT, NJ 07901
NPI-1750498028 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/22/2017 |
5/6/2025 |
SONORE, EDOUARD a/k/a SONORE EDOUARD
4 WINTERBERRY COURT
MILLER PLACE, NY 11764
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/19/2024 |
6/3/2025 |
SONZA, PATRICIO A. (MD)
8 CONSTITUTION WAY
FLEMINGTON, NJ 08822
NPI-1316974850 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/20/2010 |
|
SORBELLO, TANYA J. (LPN)
460 NEW STREET EAST
GLASSBORO, NJ 08028
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/19/2004 |
|
SORONGON, MARCELINO (MD)
192 SURREY COURT
RAMSEY, NJ 07446
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/18/2000 |
|
SOSTOWSKI, RICHARD M. (MD)
250-1 BROOK HOLLOW LANE
BERNARDSVILLE, NJ 07924
NPI-1003038951 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/20/2014 |
5/16/2016 |
SOTO, GREGORIO
153 LEWIS STREET
PERTH AMBOY, NJ 08861
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/18/2015 |
|
SOYFER, ALEXANDER
104 MAPLE HILL DRIVE
WOODBRIDGE, NJ 07095
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2001 |
|
A & B INVALID COACH
655 AMBOY AVENUE
WOODBRIDGE, NJ 07095SOYFER, ALEXANDER
655 AMBOY AVENUE
WOODBRIDGE, NJ 07095
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/21/2002 |
Permanent |
SPADORA, BREKKE (RN)
35 WOODROW AVENUE
FRANKLIN, NH 03235
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2018 |
|
SPAIN, ANTHONY B. (DMD)
113 CRESCENT AVENUE
PLAINFIELD, NJ 07060
NPI-1437316098 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/28/2002 |
|
SPANIER, CYNTHIA (PSYCH)
530 BROOKDALE DRIVE
PITTSBURGH, PA 15215
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
SPANO, ANTHONY (THERAPIST)
176 EVERGREEN STREET
HILLSDALE, NJ 07642
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/20/2003 |
|
SPAVLIK, LAURIE (RDA)
200 EAST GRANT AVENUE
SOMERDALE, NJ 08083
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/19/2001 |
|
SPEDALIERE, CARMINE (MD)
1601 KENNEDY BLVD.
NORTH BERGEN, NJ 07407
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/19/1999 |
Permanent |
SPEKTOR, IOSIF G. (MD)
54 INDIAN DRIVE
WOODCLIFF LAKE, NJ 07675
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2000 |
|
SPIEGEL, MENACHEM
1240 COUNTY LUNE ROAD EAST
LAKEWOOD, NJ 08701
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/23/2024 |
|
SPIGNER, AKOSUA (RPH)
941 LINCOLN AVENUE
GLEN ROCK , NJ 07452
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
5/15/2014 |
3/3/2020 |
SPINAPOLICE, JOSEPH (DO)
811 WASHINGTON ROAD
PARLIN, NJ 08859
NPI-1063678670 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/1/2016 |
Permanent |
SPINELLI, PAULA (CHHA)
94 FAIR STREET
HACKENSACK, NJ 07601
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/19/2017 |
|
SPIVEY, DEBRA (RN)
644 STUYVESANT AVENUE, APT. 2
TRENTON, NJ 08611
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/28/2017 |
|
SPLITTER, SAMUEL R.(MD)
1742 MARYLAND AVENUE
CAPE MAY, NJ 08204
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/4/1998 |
Permanent |
SPYRIDON-MARKER, KAREN
25 ELKINTON ROAD
ALLOWAY, NJ 08001
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/20/2002 |
|
SRISETHNIL, PUDCHONG P. (MD)
602 OLD FORGE LANE
FRANKLIN LAKES, NJ 07417
NPI-1770690315 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/10/2025 |
Permanent |
ST. PETER, LISA
PO BOX 2000
BRUCETON MILLS, WV 26525
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
11/17/2008 |
|
STAMBAUGH-LUPO, LYNDA a/k/a LYNDA LUPO
32 TOPPINGLIFE DRIVE
BAYVILLE, NJ 08721
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/29/2025 |
|
STANCH, JAMES (PSYCH)
160 S. LAKESHORE DRIVE
MANAHAWKIN, NJ 08050
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/3/2006 |
Permanent |
STANCH, JAMES M. (PSYCH)
FCI PO BOX 350
BEAVER, WV 25813
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/20/2008 |
|
STANKO-STRACK, MARY ELIZABETH (RN)
1348 MILLENNIUM COURT
TOMS RIVER, NJ 08753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2010 |
|
STANKOVIC, VESNA (LPN)
25 GRAPHIC BLVD.
BERGENFIELD, NJ 07621
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/5/2023 |
|
STANLEY, JAMES R.
PO BOX 38, FCI
FORT DIX, NJ 08640
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/20/2001 |
|
STANLEY, ROSE (CHHA)
112 HEDGEWICK DRIVE
NEWARK, DE 19702
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/4/2025 |
Permanent |
STANTON, FRANCIS X. (MD)
1327 CAMINITO BATEA
LA JOLLA, CA 92037
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
10/18/2001 |
|
STARKMAN, MOISHE (MD)
2206 YELLOWSTONE ROAD
CINNAMINSON, NJ 08077
NPI-1871609149 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/11/2017 |
Permanent |
STAVELY, LISA a/k/a LISA L. ERIKSON (LPN)
75 BEAVER AVENUE
WHITING, NJ 08759
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/14/2025 |
|
STAVITSKI, MICHAEL (RPH)
419 FAWNS RUN
MORGANVILLE, NJ 07751
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/12/2002 |
|
STEEL, BURTON B. (MD)
1 ROUND HILL ROAD
WASHINGTONVILLE, NY 10992
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/14/1984 |
DECEASED |
STEELE, JESSICA (RN)
8 SWEETBRIAR LANE
LEVITTOWN, PA 19055
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/25/2019 |
|
STEFANELLI, DANETTE
91 EAGLE ROCK AVENUE, APT. A
ROSELAND, NJ 07068
NPI-1831245760 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/28/2015 |
|
STEFANELLI, LEONARD (RPH)
11 DOGWOOD LANE
EAST HANOVER, NJ 07936
NPI-1285958645 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/14/2014 |
Permanent |
STEFANELLI, LEONARD (RPH)
11 DOGWOOD LANE
EAST HANOVER, NJ 07936
NPI-1285958645 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/29/2017 |
Permanent |
STEFANELLI, LEONARD (RPH)
MDC BROOKLYN 80 29TH STREET
BROOKLYN, NY 11232
NPI-1285958645 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2015 |
Permanent |
STEFFEN, PAUL H.
4305 APPLE LANE
PAULSBORO, NJ 08066
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2001 |
|
STEFFENS, PAUL
1778 CALICO LANE
TOMS RIVER, NJ 08753
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
4/23/2003 |
|
STEG, CHAIM CHARLES
1191 COUGHLIN STREET
LAKEWOOD, NJ 08625
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/20/2022 |
|
STEGMULLER, JOSEPH (MD)
15 POINT DRIVE
SOMERS POINT, NJ 08244
NPI-1093793911 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/7/2019 |
|
STEIG, HENRY S. (DPM)
827 CHARNWOOD DRIVE
FRANKLIN LAKES, NJ 07417
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/19/1999 |
Permanent |
STEIN, MARSHA J. (MD)
5936 HOWE STREET
PITTSBURGH, PA 15232
NPI-1831191022 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/27/2015 |
|
STEIN, MICHAEL P. (MD)
FMC LEXINGTON
LEXINGTON, KY 40512
NPI-1174607782 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
8/20/2012 |
|
STEIN, MICHAEL P. (MD)
400 RTE. 10 WEST
RANDOLPH, NJ 07869
NPI-1174607782 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/5/1999 |
|
STEINBRECHER, DEBRA (RN)
2302 WIMBLEDON WAY
BLACKWOOD, NJ 08012
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/26/2010 |
|
STEINMAN, ARTHUR C. (DO)
301 MADISON AVE
LAKEWOOD, NJ 08701
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/11/1991 |
Permanent |
STEPASCENKO, SVETLANA (CHHA)
100 STONE HILL ROAD, APT D-12
SPRINGFIELD, NJ 07081
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/22/2016 |
|
STEPHENS, ALICIA (PHARM TECH)
5322 RIVERSIDE STATION BL
SECAUCUS, NJ 07094
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/20/2010 |
|
STEPHENS, GERALYN C. (CHHA)
16119 APRIL RIDGE DRIVE
HOUSTON, TX 77083
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/28/2023 |
|
STEPHENS, JEFFREY
411 JAROB COURT
POINT PLEASANT, NJ 08742
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/20/2007 |
|
STERNE, RICHARD (NP)
1492 NEWTON STREET
PORT CHARLOTTE, FL 33952
NPI-1649673252 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2022 |
|
STEVENS, FELICIA (LPN)
56 WERT AVENUE
HAMILTON, NJ 08610
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/15/2018 |
|
STEVENS, TRACY M. (RN)
501 S. BERLIN AVE.
EGG HARBOR CITY, NJ 08215
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/20/2003 |
Permanent |
STEWART, SANDRA J (RN)
,
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/30/2022 |
|
STEWART, SHANTE (CHHA)
16B WHITE HORSE PIKE
WATERFORD WORKS, NJ 08089
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/22/2018 |
|
STIER, ERIC G. (DO)
891 OLENTANGY ROAD
FRANKLIN LAKES, NJ 07417
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/6/2000 |
Permanent |
STILL, DAWN AKA ATKINS, DAWN (CHHA)
697 EVERETT STREET
CAMDEN, NJ 08104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/6/2018 |
|
STILLWAGON-AHLERS, DAWN (COUNSELOR)
SUNSET LAKE ROAD
HARDWICK, NJ 07825
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2008 |
|
STILWELL, MELISSA (CHHA)
419 CATHERINE STREET
SOMERVILLE, NJ 08876
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/19/2004 |
|
STIMMEL-KEAY, LINDA
5 DRAYTON PLACE
WAYNE, NJ 07470
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
1/1/2014 |
|
STOKELBERG, SHOSHANA AKA KAUFMAN, SHOSHANA (LCSW)
349 JESTER COURT
OLD BRIDGE, NJ 08857
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/15/2009 |
11/7/2014 |
STOKES, RONALD L. (CHHA)
124 6TH AVENUE
LONG BRANCH, NJ 07740
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2003 |
Permanent |
STOKLEY, TWANDA (CHHA)
1372 SPRINGFIELD AVENUE, APT. 1
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/18/2017 |
|
STONE, MARY (RN)
132 CORBIN COURT
LAKEWOOD, NJ 08701
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/19/2006 |
|
STONER-WISE, CHANDRA D. (LPN)
549 W. FRANKLIN ROAD
GLASSBORO, NJ 08028
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/5/2023 |
|
STOUDEN, ELENA (DDS)
EAST 83RD ST.
NEW YORK, NY 10028
NPI-1619199882 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/19/2008 |
|
STOVEKEN, ANDREW
27-11 RAVENS CREST DRIVE
PLAINSBORO, NJ 08536
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/15/2005 |
|
STRASHNOV, ALEKSANDR (CHHA)
4816 GONIAK DRIVE
PARLIN, NJ 08859
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/18/2017 |
|
STRASSMAN, ALLAN
5 ROANOKE AVENUE
ROCKAWAY, NJ 07886
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
CARE-A-VAN WEST, INC.
120 SOUTH 20TH STREET
IRVINGTON, NJ 07111STRASSMAN, ALLAN
5 ROANOKE AVENUE
ROCKAWAY, NJ 07866
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
11/16/1998 |
|
CARE-A-VAN WEST, INC.
120 SOUTH 20TH STREET
IRVINGTON, NJ 07111STRASSMAN, CAROL (PRES)
120 S. 20 TH STREET
IRVINGTON, NJ 07111
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
3/16/1995 |
|
CARE-A-VAN WEST, INC.
120 SOUTH 20TH STREET
IRVINGTON, NJ 07111STRASSMAN, WAYNE
2 NEW COUNTRY ROAD
SECAUCUS, NJ 07094
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/5/1998 |
Permanent |
STRINE JR., WALTER M.
173 ROSE VALLEY RD.
MEDIA, PA 19063
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/11/2001 |
6/15/2023 |
STROBECK, JOHN (MD)
12 PINE TREE DRIVE
SADDLE RIVER, NJ 07458
NPI-1215936299 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/6/2016 |
|
STROBECK, JOHN (MD)
1070 RIVER ROAD, APT 411
NEW MILFORD, NJ 07646
NPI-1215936299 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/22/2024 |
Permanent |
STROGOV, EMILIA (DPM)
COOPER ROAD
SCOTCH PLAINS, NJ 07076
NPI-1225115801 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/24/1995 |
|
STRUM, MORTON W.
1360 ARBORDALE ROAD
PHILADELPHIA, PA 19151
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
SUGGS, SHANTAYA (CHHA)
115 HALSTED STREET
EAST ORANGE, NJ 07018
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/26/2017 |
|
SUH, JEFFREY (ACCUPUNCTURIST)
FORT DIX FCI, PO BOX 2000
JOINT BASE MDL., NJ 08640
NPI-1336523497 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/23/2016 |
|
SULAIMON, TANFEEK (CHHA)
321 GARFIELD AVENUE
TRENTON, NJ 08629
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/22/2018 |
|
SULIMENKO-HOFFMAN, KATHLEEN AKA HOFFMAN, KATHLEEN (LPN)
99 CREEK ROAD
BRICK, NJ 08724
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/13/2018 |
|
SULLIVAN, CYNTHIA AKA CRITCHFIELD, CYNTHIA (RPH)
PIN OAK COURT
SHAMONG, NJ 08088
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/20/2008 |
6/15/2017 |
SULLIVAN, JOHN M.
PO BOX 2000
LEWISBURG, PA 17837
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/30/1998 |
Permanent |
SULLIVAN, NOELLE (CHHA)
H-9 HUNTER HILLS APARTMENTS
FLEMINGTON, NJ 08822
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/14/2017 |
|
SUN, KENNETH (MD)
382 EPPS STREET
WIND GAP, PA 18091
NPI-1881693109 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/3/2017 |
|
SUN, KENNETH (MD)
15 MOUNTAIN TOP ROAD
WIND GAP, PA 18091
NPI-1881693109 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2018 |
|
SUNG, KYUNG EUN (DDS)
428 RUSSELL AVENUE
EDGEWATER, NJ 07020
NPI-1215122205 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
9/20/2012 |
2/19/2020 |
SURECK, MORRIS M. (OD)
12 NORTH 4TH AVENUE
HIGHLAND PARK, NJ 08904
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/5/1988 |
Permanent |
SUSSMAN, GERALD (DO)
6 EAST FIRST AVENUE
RUNNEMEDE, NJ 08708
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/1998 |
|
SUTOR, COREY
101 WEDGEWOOD DRIVE
EGG HARBOR TOWNSHIP, NJ 08234
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
6/11/2024 |
|
SUTTON, DEJA (CHHA)
802 MAIN STREET 1-3
TOMS RIVER, NJ 08753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2017 |
|
SVERDLOV, GREGORY
269 SHEFFIELD ST.
MOUNTAINSIDE, NJ 07092
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/7/1998 |
Permanent |
SWAIN, CHERIE (CHHA)
2217 NORTH 43RD STREET
PENNSAUKEN, NJ 08110
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/6/2018 |
|
SWARAY, MAYANGBE (CHHA)
314 MORRIS AVENUE
NEWARK, NJ 07103
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/14/2014 |
|
SWEITZER, JANET
950 ORCHARD AVENUE, LOT 28
CAMP HILL, PA 17011
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
SYED, ABID
7 JANE STREET
EAST HANOVER, NJ 07936
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
5/2/2023 |
|
SZARSZEWSKI, MARK A. (RPH)
6 MARIGOLD CT.
EDISON, NJ 08820
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2005 |
5/25/2023 |
SZTYBEL, ELVIRA
35 PEACHTREE ROAD
OAKHURST, NJ 07755
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/18/2001 |
Permanent |
TABBY, DAVID S. (DO)
217 SPRINGHOUSE LANE
MERION STATION, PA 19004
NPI-1346292901 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/4/2022 |
|
TABOTABO, ARMANDO (MD)
12 WQEST FRONT STREET
KEYPORT, NJ 07735
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/12/2001 |
Permanent |
TADROS, AMIR (RPH)
6 ALEXANDER CT.
JERSEY CITY, NJ 07305
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/30/2010 |
2/5/2018 |
TADROS, AMIR (RPH)
6 ALEXANDER COURT, APT 6N
JERSEY CITY , NJ 07305
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
12/20/2012 |
2/5/2018 |
CITILAB CORPORATION
333 NORTH BROAD STREET
ELIZABETH, NJ 07028TAFT, ARNOLD (PHD/LAB DIR)
333 NORTH BROAD STREET
ELIZABETH, NJ 07028
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/21/1997 |
|
TANDLER, ROBERT (OD)
792 GREEN LANE
UNION, NJ 07083
NPI-1104812924 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/29/2016 |
10/27/2017 |
TAORMINA, PHILIP (MD)
1 APPLETREE LANE
SEWELL, NJ 08080
NPI-1689810723 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/5/2018 |
|
TAPPER, FREDERIC S. (DO)
39 BROOKSIDE DRIVE
WARREN, NJ 07059
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/21/2000 |
Permanent |
TAPPIA, YEALESEH (CHHA)
941 IVORIE COURT
BURLINGTON, NJ 08016
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
TARA, HAROLD H. (MD)
48 BROOKWOOD DR
WAYNE, NJ 07470
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
DECEASED |
TARANTO, SHERRY L. (DENTAL HYGIENTIST)
26 COOMES STREET
NORWICH, NY 13815
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/2/2012 |
|
TARASEVICH, LISA AKA ADAIR, LISA (LPN)
206 LAKEHURST AVE., APT.B
NATIONAL PARK, NJ 08063
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2002 |
|
TARKAS, SURBHI
8 CARLTON COURT
EAST BRUNSWICK, NJ 08816
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
6/23/2004 |
|
TARTE, DEWAYNE (LPN)
4014 HAMILTON DRIVE
VORHEES, NJ 08043
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/17/2019 |
|
TARVER, JOLYCE (CHHA)
15 HEATHWOOD AVENUE
JACKSON, NJ 08527
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/22/2017 |
|
TASCA, ANTHONY J. (RN)
11 SAWGRASS COURT
BLACKWOOD, NJ 08012
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2003 |
6/22/2005 |
TAUSCHEK, JENNIFER L. (CHHA)
154 MAPLE AVENUE
TUCKERTON, NJ 08087
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2005 |
|
TAVERA, CESAR
812 LONGWOOD AVENUE
CHERRY HILL, NJ 08002
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/11/2017 |
|
TAVERA, MARIA
812 LONGWOOD AVENUE
CHERRY HILL, NJ 08002
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/11/2017 |
10/3/2019 |
TAVERA, MARIA
812 LONGWOOD AVENUE
CHERRY HILL, NJ 08002
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/3/2019 |
|
TAYLOR, BARBARA J. AKA MONDELO, BARBARA AKA DOMINICO, MARIA
KENTWOOD BLVD
BRICK, NJ 08724
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
10/24/2008 |
|
TAYLOR, JANICE (CHHA)
66 DUFFIELD DRIVE
SOUTH ORANGE, NJ 07079
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
TAYLOR, KANIKA (CHHA)
17 HUNTINGTON TERRACE, FLOOR 2
NEWARK, NJ 07112
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/10/2019 |
|
TAYLOR, STEVEN R. (RN)
25 SYLVAN LANE
WILLINGBORO, NJ 08046
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2017 |
|
TAYLOR, THOMAS VINCENT (MD)
1402 CASTLE COURT
HOUSTON, TX 77006-5704
NPI-1356454292 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/1/2017 |
|
TAYLOR, TIANN (RN)
PO BOX 4004
CLINTON, NJ 08809
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/20/2006 |
|
TEDESCO, MATTHEW
218 BELHAVE AVENUE
LINWOOD, NJ 08221
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/11/2023 |
|
TEDESCO, NICHOLAS
309 FOREST DRIVE
LINWOOD, NJ 08221
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/11/2023 |
|
TEDESCO, NICHOLAS
P.O. BOX 2000
JOINT BASE MDL, NJ 08640
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2024 |
|
TEJADA, LEYDA TORREZ (CHHA)
12 KOSSUTH STREET
NEWARK, NJ 07105
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/31/2023 |
|
TELANG, FRANK W. (MD)
1030 N. KINGS HGHWY
CHERRY HILL, NJ 08034
NPI-1497798706 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/28/2014 |
|
TELANG, FRANK W. (MD)
1030 W. KINGS HIGHWAY
CHERRY HILL, NJ 08034
NPI-1497798706 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/5/1997 |
Permanent |
TELGHEDER, MARGARET (LAB)
75 SPRING VALLEY RD
MONTVALE, NJ
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2002 |
|
TENDENCIA, CHONA (RN)
72 MANCHESTER COURT, APT D
FREEHOLD, NJ 07728
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/19/2023 |
|
TENSLEY, SHENEQUA
364 EAST MOORE STREET
NORRISTOWN, PA 19401
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
TERCHIO, GAETANO FRED
104 E PALISADE BLVD
PALISADE PARK, NJ 07650
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
TERPENNING, CLARENCE (PHD)
303 CARTER ROAD
PRINCETON, NJ 08540
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/19/1986 |
Permanent |
TERWILLIGER, KRISTINE (RN)
1 DUANE STREET
JAMESBURG, NJ 08831
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/25/2016 |
|
TESCHNER, TERRI (PHARM TECH)
300 NORTH BLACK HORSE PIKE, APT. B1
RUNNEMEDE, NJ 08078
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/26/2016 |
|
THAMES, DOUGLAS A. (MD)
218 WEST AVENUE
PITMAN, NJ 08071
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/20/2001 |
|
THERMITUS, YVROSE a/k/a YVROSE THOMPSON (RN)
642 CALYLE PLACE
UNION, NJ 07083
NPI-1164925822 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/20/2024 |
|
THEUNE, CHRISTOPHER (DO)
5678 BERKSHIRE VALLEY RD.
OAK RIDGE, NJ 07438
NPI-1639141583 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/15/2012 |
10/15/2015 |
THEUNE, CHRISTOPHER (DO)
32 WARNER ROAD
NEWTON, NJ 07860
NPI-1639141583 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/5/2017 |
|
THILLAINATHAN, ANANTHAKUMAR (MD)
5 CAMDEN PLACE
NEW HYDE PARK, NY 11040
NPI-1285900621 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/15/2023 |
|
THOMAS, EMMANUEL (CHHA)
415 W. READING AVENUE
PLEASANTVILLE, NJ 08232
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/4/2025 |
|
THOMAS, ERIC (MD)
8460 EVERGREEN DRIVE
HELENA , MT 59602
NPI-1528378072 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/22/2018 |
Permanent |
THOMAS, GWENDOLYN (LPN)
48 ROANOKE STREET
WOODBRIDGE, NJ 07095
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/3/2017 |
|
THOMAS, LISA M. (CHHA)
402 UNION AV, APT. #3
IRVINGTON, NJ
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
4/20/1999 |
Permanent |
THOMAS, TANIQUE (CHHA)
447 PREAKNESS AVENUE
PATERSON, NJ 07502
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/17/2018 |
|
THOMAS-MCNAIR, GLORIA
590 BELLVUE AVENUE
TRANTON, NJ 08618
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/21/1999 |
|
THOMPSON III, VINCENT JOSEPH
FORT DIX FCI, PO BOX 2000
JOINT BASE MDL, NJ 08640
NPI-1174526180 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2024 |
|
THOMPSON, ARTHUR V.
855 THORNHILL COURT
LAKEWOOD, NJ 08701
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
1/19/2010 |
|
THOMPSON, DAPHNE (CNA)
2247 HIGH STREET
ORANGE, NJ 07050
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/29/2002 |
|
THOMPSON, DEBORAH (LPN)
1006 COLLINGS AVE.
CAMDEN, NJ 08102
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/19/2003 |
|
THOMPSON, KENNETH H. (EMT)
408 SADDLE COURT
FLEMINGTON, NJ 08822
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/28/2003 |
|
THOMPSON, LORNA (MD)
20 OAK POINT DRIVE SO.
BAYVILLE, NY 11709
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2000 |
|
THOMPSON, SHAKEEMA (CHHA)
1034 ANNA STREET
ELIZABETH, NJ 07201
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/26/2018 |
7/12/2022 |
THOOMPALLY, SRINATH (RPH)
18 LAFAYETTE CIRCLE
TOTOWA, NJ 07512
NPI-1235381443 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
12/5/2013 |
12/17/2015 |
THOTTEMPUDI, VENKATTA
13 VINCENT BEHAN BLVD
EDISON, NJ 08837
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/12/2012 |
|
THOTTEMPUDI, VENKATTA
13 VINCENT BEHAN BLVD
EDISON, NJ 08837
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/9/2013 |
|
THUMMEL, HOPE (LPN)
246 WEST BROAD STREET
PAULSBORO, NJ 08066
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/9/2019 |
|
TICE, LINDSEY (LPN)
20 PARVINS MILL ROAD
BRIDGETON, NJ 08302
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2005 |
|
TIDD, MILES (LPN/RN)
26 CORAL TREE CT.
TRENTON, NJ 08648
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2005 |
1/9/2012 |
TIGHE, GERALD
20 SOUTH ARLENE DRIVE
WEST LONG BRANCH, NJ 07764
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/26/2018 |
|
TIMMONS, JAWANNA (CHHA)
609 FOURTEENTH AVENUE, 1ST FL
PATERSON, NJ 07504
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/10/2018 |
|
TISCORNIA, KIMBERLY (RN)
18 TORNE MOUNTAIN ROAD
WEST MILFORD, NJ 07480
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2005 |
|
TITUS, AJEEB JOHN (MD)
354 CLICKO LANE
EAST STROUDSBURG , PA 18301
NPI-1124065966 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2023 |
|
TOBACK, BARRY (RPH)
1375 RIVER RD.
EDGEWATER, NJ 07020
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/19/2003 |
Permanent |
TOFANI, NANCY
114 COUNTY ROAD 513
PITTSTOWN, NJ 08867
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/14/2000 |
8/29/2022 |
TOMLIN, CANDICE (PHARM TECH)
38-19 FAIRLAWN AVENUE
FAIRLAWN, NJ 07410
NPI-1255517934 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/9/2016 |
3/16/2023 |
TOMLIN, TERESA L. (DPM)
232 KRISTINE AVENUE
MANAHAWKIN, NJ 08050
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/5/2008 |
|
TOMPKINS, AMBER (LPN)
17 LEHIGH ROAD
PARLIN, NJ 08859
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/15/2018 |
|
TONG, DARLENE M. (RPH)
108 LOWER LANDSDOWN ROAD
ANNADALE, NJ 08801
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
11/12/2009 |
|
TORIBIO, ANTHONY (X-RAY TECH)
11 BYRON DRIVE
LOPATCONG, NJ 08865
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/28/2001 |
|
TORNARI, VINCENT
637 HARRISON DRIVE
NORTHFIELD, NJ 08225
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/11/2023 |
|
TORO, NORMARY (CHHA)
1173 ATLANTIC AVENUE, APT. B
CAMDEN, NJ 08104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
TORPPEY, JONI (LPN)
28 CHURCH ROAD
NEWTON, NJ 07860
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/5/2017 |
|
TORRES, BRENDA HICHENS
94 COCELLI DRIVE, APT 94
BRIDGETON, NJ 08302
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/25/2025 |
|
TORRES, FRANCES
437 STUYVESANT AVENUE APT
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/27/2007 |
|
TORRES, JAIME
14 STREET, U-25 VILLARICA
BAYAMO, PR 00959
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/7/2000 |
|
TORRES, MANUEL G.
ST. 18 ATE, PRADERA
TOA BAJA, PR 00940
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/7/2000 |
|
TORRES, MILESTY (CHHA)
407 NORTH 31ST STREET
CAMDEN, NJ 08105
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2017 |
|
TORRES, NELLY (CHHA)
119 WEST GRAPE STREET
VINELAND, NJ 08360
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2023 |
|
TORRESS, KRISTINA (CHHA)
53 STEGMAN STREET, APT. #4
JERSEY CITY, NJ 07305
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/24/2018 |
|
TOSCANO, SYLVIA
13 NORTHGATE WAY
TOMS RIVER, NJ 08753
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
8/12/2013 |
11/14/2018 |
TOTH, TEREZIA M. (MD)
9 N 2ND AVE.
HIGHLAND PARK, NJ 08904
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/6/2006 |
|
TOUSSAINT, VALENTINA
240 WEST 104TH STREET
NEW YORK, NY 10025
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2006 |
|
TOY, SUSAN
727 SUMMIT ROAD
UNION, NJ 07083
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/9/2017 |
|
TRACY, DORIS (RN)
90 CITADEL DRIVE
JACKSON, NJ 08527
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2024 |
|
TRASTER, LAWRENCE
19 BRAEMAR DRIVE
WAYNE, NJ 07470
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/21/1983 |
Permanent |
TRAVERSO, JOSEPH L. (MD)
5 OLD SALEM ROAD
W. ORANGE, NJ 07052
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2005 |
|
TRAYNOR, PATRICK
2314 WOODLAND ROAD
ABINGTON, PA 19001
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/5/2003 |
|
TREGO-CAMPION, ANITA (RPH)
136 S. FELLOWSHIP ROAD
MAPLE SHADE, NJ 08052
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2005 |
|
TREMO, GREGORY (RPH)
13276 WHIPPINGHAM PARKWAY
NEW CARROLTON, VA 23314
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/20/2006 |
|
TRENTACOSTA, GREG S. (DC)
1565 RATZER RD.
WAYNE, NJ 07470
NPI-1720293079 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2005 |
|
TRIMBLE, ABIGAIL J. (RN)
460 SAINT ANDREWS PLACE
MANALAPAN, NJ 07726
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/15/2024 |
|
TRINIDAD, TITO B. (MD)
PO BOX 1000 #10912-068
LEWISBURG, PA 17837
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/10/1996 |
|
TRIVEDI, AMRITAL (PHD)
20 CYPRESS ROAD
BURLINGTON, NJ 08016
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/1978 |
Permanent |
TROLLINGER, ROBERT J. (MD)
212 ROUTE 541 NORTH
MEDFORD, NJ 08055
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/10/2001 |
Permanent |
, TSIRKINA, NATALIA
13675 PHILMONT AVENUE
PHILADELPHIA, PA 19116
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
TUCHMAN, ALAN P. (DPM)
WEST MAIN STREET
FREEHOLD, NJ 07728
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/21/2008 |
8/29/2011 |
TUCKER, APRIL (CHHA)
193 BENNER AVENUE
NEWARK, NJ 07112
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/14/2017 |
|
TUCKER, BURT A. (DDS)
530 BRICK BLVD
BRICKTOWN, NJ 08723
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/31/1999 |
DECEASED |
TUCKER, KAREN, E. (DPM)
1 ERYNWOOD AVENUE
MARLTON, NJ 08053
NPI-1992052930 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/20/2002 |
7/15/2016 |
TUCKER, SUZANNE (RN)
127 GAYWOOD AVENUE
COLONIA, NJ 07067
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2001 |
|
TUFARIELLO, VINCENT
30 OLD FARM RAOD
BASKING RIDGE, NJ 07920
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/5/2025 |
|
TULSANIA, NITAN
40 BROOKSIDE ROAD
EDISON, NJ 08817
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/27/2004 |
|
TUMAS, MARY (DC)
537 FISK AVENUE
BRIELLE, NJ 08730
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/28/2014 |
|
TUMIWA, ARNOLD (RN)
44 CIRCLE PLACE
LAKEWOOD, NJ 08701
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2018 |
|
TUMPATI, PRABHAKARA RAO (MD)
1539 SHREWSBURY DRIVE
BENSALEM, PA 19020
NPI-1487844148 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/8/2025 |
|
TUNG, MING C. (DPM)
MITCHELL AVENUE
EAST BRUNSWICK, NJ 08816
NPI-1043387608 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/24/2007 |
|
TURTON, IAN (LPN)
52 BAY SHORE DRIVE
TOMS RIVER, NJ 08753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/24/2018 |
|
TWEED, DONNA (RN)
60 BAYSHORE ROAD
CAPE MAY, NJ 08204
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/30/2019 |
Permanent |
TWUMASI, REGINA (CHHA)
54 WINDING WOOD DRIVE, APT 8A
SAYREVILLE, NJ 08872
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/26/2024 |
|
TYER, DOUGLAS D.
175 1ST STREET APT. 16L
NEWARK, NJ 07102
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/22/2005 |
|
TYRELL, MARK N. (RPH)
58 HAVERHILL AVE.
LITTLE FALLS, NJ 07424
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/19/2004 |
|
TYSHKOV, MICHAEL (MD)
87 SHREWSBURY ROAD
LIVINGSTON, NJ 07039
NPI-1902882038 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/8/2019 |
Permanent |
UDEOKORO, IKECHUKWU
19-21 AGATE PLACE, SUITE 1A
NEWARK, NJ 07104
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/7/2023 |
|
UHLIG, CYNTHIA
204 WYOMING STREET
WESTFIELD, NJ 07090
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2006 |
|
UHUNMWANGHO, OZIEGBE (CHHA)
818 SOUTH 18TH STREET
NEWARK, NJ 07108
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/12/2017 |
|
UKO, BRIDGET (CHHA)
47 HEMPSTEAD DRIVE
SOMERSET, NJ 08873
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/14/2017 |
Permanent |
UMSTEAD, LINDA (CHHA)
143 NORTHUMBERLAND DRIVE
TOMS RIVER, NJ 08757
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/9/2018 |
|
URVINA, GINA (CHHA)
169 JACKSON STREET, APT. 3
PASSAIC, NJ 07055
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/31/2017 |
|
VACCARINO, ROBERT A. (MD)
27 BEACH 220TH STREET
BREEZY POINT, NY 11697
NPI-1922086354 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/25/2023 |
|
VACCARINO, ROBERT A. (MD)
27 BEACH 220TH STREET
BREEZY POINT, NY 11697
NPI-1922086354 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2023 |
|
TNT MEDICAL SUPPLIES
135 HAZEL STREET, APT. 65
CLIFTON, NJ 07011VALDES JR., ALFREDO
135 HAZEL STREET, APT. 65
CLIFTON, NJ 07011
NPI-1780644427 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/29/2018 |
|
VALENCIA, RAFAEL (MD)
146 LAKEVIEW DRIVE
GIBBSBORO, NJ 08026
NPI-1518045525 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/9/2017 |
Permanent |
VALENTINO, STEVEN JOHN (DO)
406 WILLIAMSON ROAD
GLADWYNE, PA 19035
NPI-1366400798 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/18/2023 |
|
VALENZUELA, ROGER (CHHA)
517 LINCOLN STREET
UNION CITY, NJ 07087
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
VALLEJOS, ANA (CHHA)
943 NORTH BROAD STREET
ELIZABETH, NJ 07208
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/14/2007 |
|
VALMON, CAMILLE (CHHA)
1106 SUMMER WIND DRIVE
JONESBORO, GA 30236
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
VAN VLEET, ERIC
801 ANDREWS AVENUE, APT 3
DELRAY BEACH, FL 33483
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
5/9/2024 |
|
VANAMAN, JODI L. (RN, LPN)
55 ROUTE 35 N #20
NEPTUNE, NJ 07753
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/14/2024 |
|
VANDYK, TRICIA
1412 ISABELLE COURT
BRICK, NJ 08724
NPI- |
Medical
Criminal Offense |
Disqualification Health & Senior Services
Medical Assistance (Medicaid) |
8/11/2012 |
8/10/2014 |
VANSCIVER, SUZANNE (RN)
1187 NESHAMINY VALLEY DRIVE
BENSALEM, PA 19020
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/28/2017 |
|
VARGAS, IRCANIA (RN)
618 HILLTOP DRIVE APT B9
TRENTON, NJ 08621
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/31/2023 |
|
VARSOS, ARISTIDES G. (MD)
28 47 37TH ST
ASTORIA, NY 11103
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/24/1986 |
DECEASED |
INDEPENDENCE MEDICAL TRAN
3 PARKWOOD DRIVE
SOUTH AMBOY, NJ 08879VASKO, OLGA
3 PARKWOOD DRIVE
SOUTH AMBOY, NJ 08879
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/10/2003 |
11/18/2019 |
VASOYA, PRAVIN #41549-050 (MD)
METROPOLITAN DETENTION CN
BROOKLYN, NY 11232
NPI-1770665135 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/1/2009 |
|
VASSERMAN, ALEKSANDR (PARAMEDIC)
851 RED LION ROAD
PHILADELPHIA, PA 19115
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
VASSERMAN, IRINA
851 RED LION ROAD
PHILADELPHIA, PA 19115
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
VASTEY, GARDY (DC)
1144 USTLER ROAD
APOPKA, FL 32712
NPI-1114148806 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/28/2017 |
|
VASWANI, VIJAY
9 TYNEMOUTH DRIVE
LUMBERTON, NJ 08048
NPI-1194785956 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/15/2016 |
|
VAZQUEZ, AIDA I. (CHHA)
1464 PRINCESS AVENUE, APT. 2
CAMDEN, NJ 08103
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/28/2023 |
|
VECCHIONE, JOHN (DDS)
2 LORRAINE DRIVE
PARK RIDGE, NJ 07656
NPI-1710926076 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/31/2016 |
|
VECCHIONE, JOHN (DDS)
1 CAROL DRIVE
ENGELWOOD CLIFFS, NJ 07632
NPI-1710926076 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
VEGA, DEBORAH
2409 BOOKER AVENUE
UPPER CHICHESTER, PA 19014
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
VEHOVEC, CHRISTOPHER
38033 LAKE SHORE BLVD.
WILLOUGHBY, OH 44094
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/23/2024 |
|
VEKEMAN, JEFFREY DENNIS (RN)
114 KARENLYNN DR
FRANKINVILLE, NJ 08322
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/24/2023 |
|
VELEZ, MAXIMINA (CHHA)
119 19th STREET
UNION CITY, NJ 07087
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/31/2023 |
|
VELOSO, CESAR (MD)
532 AMSTERDAM AVENUE
RIDGEWOOD, NJ 07450
NPI-1104800333 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/20/2018 |
|
VENANZI, ENZO (DO)
107 NORTH BROAD STREET
WOODBURY, NJ 08096
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/9/1996 |
Permanent |
VENKATRAM, PRABHAKAR (MD)
3305 VILLAGE DRIVE
AVANEL, NJ 07001
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/28/1998 |
Permanent |
VENTURA, MARIA (CHHA)
135 BELMONT STREET #204
JERSEY CITY, NJ 07304
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/22/2017 |
|
VERBARO, DENNIS (DC)
384 MAIN STREET
CHESTER, NJ 07930
NPI-1558426122 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
VERDELL, CLARENCE (MD)
107 WHITEHALL DRIVE
VOORHEES , NJ 08043
NPI-1649206376 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2018 |
|
VERGARA, NATALIE (LPN)
2413 FEDERAL STREET, UNIT 11
PHILADELPHIA, PA 19146
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/30/2023 |
|
VERSCHOOR, STEVE
3412 E. RIVERNEST LANE
BOISE, ID 83706
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2023 |
|
VICENTI, CARMILLA C. (MD)
40-15 QUAIL RIDGE RD.
PLAINSBORO, NJ 08536
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/18/1999 |
|
VICIOSO, MARGARITA (MD)
7801 BUSTLETON PIKE
PHILADELPHIA, PA 19152
NPI-1922058932 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2015 |
|
VIGGIANO, DIANE (RN)
188 COACHMAN DRIVE N
FREEHOLD, NJ 07728
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/22/2017 |
5/17/2022 |
VILLAMOR, MANUEL (THERAPIST)
9030 SW 29TH TERRACE
MIAMI, FL 33155
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/20/2005 |
|
VILLARE, ANTHONY (MD)
560 MANTUA AVENUE
PAULSBORO, NJ 08066
NPI-1114954054 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/15/2022 |
|
VILLARE, ANTHONY (MD)
560 MANTUA AVENUE
PAULSBORO, NJ 08066
NPI-1114954054 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/30/2023 |
|
VILLARE, ANTHONY WILLIAM (MD)
53045 LAKESHORE PLACE
BETHANY BEACH, DE 19930
NPI-1114954054 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/20/2023 |
|
VILLONE, MARY
DUNMORE STREET
THROOP, PA 18512
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/4/2005 |
|
VILSHTEYN, ROSTISLAV
50 PAMELA LANE
STATEN ISLAND, NY 10304
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/31/2012 |
|
VINCI, JUDITH (RN)
202 BRUNSWICK AVENUE
SPOTSWOOD, NJ 08884
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/19/2003 |
|
VINING, DONNA (DO)
33 1/2 PEMBROKE ROAD
DANBURY, CT 06811
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/5/2001 |
Permanent |
VINUELA, ANDRES (MD)
1910 NE 27TH COURT, APT. 1
LIGHTHOUSE POINT, FL 33064
NPI-1649539479 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/15/2019 |
|
VIRZI, JOSEPH
PO BOX 164
JAMESBURG, NJ 08831
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/9/1996 |
|
VISCOMI, DOMINIC A. (DDS)
926 DUCK POND ROAD
NEWTON, NJ 07860
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/31/2001 |
Permanent |
VISCONTI, PAUL A. (DO)
120 OLD COMMACK ROAD
KINGS PARK, NY 11754
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/27/2001 |
10/25/2013 |
SURF PHARMACY
17 CORNELL PLACE
ENGLISHTOWN, NJ 07726VITALE, JACK (RPH)
17 CORNELL PLACE
ENGLISHTOWN, NJ 07726
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
6/22/1999 |
Permanent |
VITALE, JACK (RPH)
17 CORNELL PLACE
MANALAPAN, NJ 07726
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/2/2000 |
|
VITALI, JOHN (MD)
1 SHIRA LANE
MANALAPAN, NJ 07726
NPI-1609829985 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/22/2016 |
4/5/2022 |
VITALI, JOHN (MD)
1 SHIRA LANE
MANALAPAN, NJ 00726
NPI-1609829985 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/3/2016 |
4/5/2022 |
VOGEL III, FRANK (MD)
271 BELMONT PLACE
MAHWAH, NJ 07430
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/28/2014 |
|
VOGEL, BARRY M. (MD)
200 HIGHLAND AVENUE
GLEN RIDGE, NJ 07028
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/8/2000 |
Permanent |
VOROBYEV, LEONID (MD)
PERRY STREET
MORGANVILLE, NJ 07751
NPI-1245259431 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2008 |
6/17/2014 |
VOUDOURIS, APOSTOLOS (MD)
3 HUNTERS CROSSING ROAD
SOMERSET, NJ 08873
NPI-1801160767/0902842446/1235437534 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/16/2017 |
|
VOUDOURIS, APOSTOLOS (MD)
3 HUNTERS CROSSING ROAD
SOMERSET, NJ 08873
NPI-1801160767/0902842446/1235437534 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
12/3/2018 |
|
VOUDOURIS, APOSTOLOS (MD)
FMC DEVENS, PO BOX 879
AYER, MA 01432
NPI-1801160767/0902842446/1235437534 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/18/2019 |
|
VOUDOURIS, APOSTOLOS (MD)
130 WADSWORTH AVENUE, APT. 62
NEW YORK, NY 10033
NPI-1902842446 / 1801160767 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/18/2019 |
|
VOYTENKO, CONSTANTINE (DC)
2780 WEST 5TH STREET, APT 12A
BROOKLYN, NY 11224
NPI-1174556229 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/11/2016 |
|
VOZNYUK, PETRO (CHHA)
5 PULAWSKI AVENUE
SOUTH RIVER, NJ 08882
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/18/2017 |
|
VOZNYUK, PETRO (CHHA)
5 PULAWSKI AVENUE
SOUTH RIVER, NJ 08882
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
WACTOR, DONNA (RN)
71 FOREST STREET
MONTCLAIR, NJ 07042
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/19/2003 |
|
WADE, ROBIN R. aka REATH, ROBIN R. (RN)
98 OAK STREET, APT 4007
LINDENWOLD, NJ 08080
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/11/2023 |
|
WAGERS, DAVID (OD)
540 OLD FARM ROAD
PALMYRA, PA 17078
NPI-1710928239 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
WALDRON, JOHN F.
920 CEDARBRIDGE ROAD
BRICKTOWN, NJ 08723
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/21/1979 |
Permanent |
WALKER, ASHLEY (RN/PA)
841 HILLTOP ROAD
ERIE, PA 16509
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
WALKER, BARBARA (CHHA)
120 ORATON PARKWAY
EAST ORANGE, NJ 07017
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2002 |
|
WALKER, RUSSELL
910 MORNING GLORY COURT
JACKSON, NJ 08527
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/10/2010 |
|
WALKER, SHAUNTAE KENYATTA (NP)
FCI MARIANNA PO BOX 7007
MARIANNA, FL 32447
NPI-1568828325 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/20/2024 |
|
WALLER, ALFONSO (MD)
131 37TH STREET
UNION CITY, NJ 07087
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/14/1983 |
Permanent |
WALLIS, JODIE (RN)
601 FAIRVIEW LANE
WILLINGBORO, NJ 08046
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/18/2001 |
|
WALTERS, SAMUEL R. (MD)
215 FOX HILL RUN
ROCK TAVERN, NY 12575
NPI-1144368606 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/8/2025 |
|
WANNAMAKER, MEGAN (DO)
34 OLDIS STREET
ROCHELLE PARK, NJ 07662
NPI-1750643557 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/29/2025 |
|
WARD, BRITTANY (CHHA)
1256 PARK BLVD.
CAMDEN, NJ 08106
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/4/2025 |
|
WARD, CARMEN
402 WILLOW COURT
FLEMINGTON, NJ 08822
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
12/14/2022 |
5/25/2023 |
WARD, KEVIN (DDS)
27 FIRETOWER ROAD
BUDD LAKE, NJ 07828
NPI-1487842647 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/15/2017 |
|
WARNER, TENNEH J. (RN)
344 ATLANTIC AVENUE
TRENTON, NJ 08629
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/222024 |
|
WASHINGTON JR., ANKOMO (CHHA)
174 EAST 6TH STREET
CLIFTON, NJ 07011
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
WASHINGTON, JOHN
2 TUERS PLACE
MONTCLAIR, NJ 07043
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/29/1997 |
|
WASHINGTON, WAH'TAYVIA (CHHA)
144 BIDWELL AVENUE
JERSEY CITY, NJ 07305
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
WASHINGTON-BHAMRE, SHARON (RN)
166 MAPLE STREET, APT. 23
ROSELLE PARK, NJ 07204
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/2/2020 |
|
WASSEF, ADEL A. (MD)
123 SOUTH MUN AVENUE
EAST ORANGE, NJ 07019
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/18/1998 |
Permanent |
WATSON, LORENZO
500 ADAMS LANE
NORTH BRUNSWICK, NJ 08902
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/21/2016 |
|
WATSON, MARC (MD)
6 POMPTON AVENUE, SUITE 11
CEDAR GROVE, NJ 07009
NPI-1578605929 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/14/2024 |
Permanent |
WATSON, MARC C. (MD)
912 POMPTON AVE #9B1
CEDAR GROVE, NJ 07009
NPI-1578605929 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/1/2001 |
9/23/2022 |
WATSON, TRACEY L. (LPN)
1 GRUMMAN AVE. APT. 4F
NEWARK, NJ 07112
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/23/2006 |
|
WATZMAN, HOWARD (MD)
PO BOX 1000
LORETTO, PA 15940
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/30/2007 |
|
WEAH, JEROME
P.O. BOX 190
AVENEL, NJ 07001
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/14/2011 |
|
WEATHERS, DAVID
4368 WILDER AVENUE
BRONX, NY 10466
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
5/2/2023 |
6/18/2024 |
WEATHERS, DAVID
4368 WILDER AVENUE
BRONX, NY 10466
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/19/2024 |
|
WEAVER, LINDA MARIE a.k.a. WEAVER, LYN MARIE
FCI PHOENIX 37910 N. 45TH AVENUE
PHOENIX, AZ 85086
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2024 |
|
WEAVER, LYN MARIE a.k.a. WEAVER, LINDA MARIE
FCI PHOENIX 37910 N. 45TH AVENUE
PHOENIX, AZ 85086
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2024 |
|
WEBB, ALNESHA (CHHA)
328 IRVINE TURNER ROAD
NEWARK, NJ 07108
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/29/2018 |
|
WEBB, CURTIS O. (RN)
110 CROSSHILL DR
BANGOR, PA 18013
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/19/2002 |
|
WEBB, LATISA (CHHA)
1060 BROAD STREET, APT. 504
NEWARK, NJ 07102
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/9/2019 |
|
WEBER, MARC (DDS)
326 BROAD STREET
RED BANK, NJ 07701
NPI-1609064062 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
11/5/2009 |
9/30/2010 |
WEBER, MARGARET (LPN)
2920 STATE RTE. 23
NEWFOUNDLAND, NJ 07435
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/18/2003 |
|
WEBSTER, THOMAS (MD)
5900 WALNUT SPRINGS BLVD. APT 102
SYLVANIA, OH 43560
NPI-1154432094 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/15/2024 |
|
WEIDER, ABE
3301 FOSTER AVENUE
BROOKLYN, NY 11203
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
12/21/2001 |
|
WEIGAND, DAVID (RN)
310 VILLAGE DRIVE
SOMERSET, NJ 08873
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/20/2001 |
|
WEIN, FRED R. (RPH)
111 TANGERINE DRIVE
MARLBORO, NJ 07746
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/19/2005 |
|
WEINER, WILLIAM (DO)
8 LEONARD DRIVE
EAST ROCKAWAY, NY 11518
NPI-1912997586 |
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/19/2024 |
|
WEINSTEIN, LEONARD (MD)
1 TRENT ROAD
MONROE TWP., NJ 08831
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2003 |
RETIRED |
WEINSTEIN, MARTIN H. (DPM)
601 2ND AVENUE
LONG BRANCH, NJ 07740
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/19/2008 |
|
WEINTRAUB, FREDERICK (DPM)
17 HARVEY LANE
UPPER SADDLE RIVER, NJ 07458
NPI-1225131550 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/15/2016 |
|
MANAGEMENT CORP. OF AMERI
8900 S.W. 61ST STREET
MIAMI, FL 33156WEISELBERG, ALAN
8900 S.W. 61ST STREET
MIAMI, FL 33156
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/5/2000 |
Permanent |
WEISS, CHERIE (PA)
801 ABBY ROAD
MIDDLETOWN, NJ 07748
NPI-1861435828 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/16/2015 |
|
WEISZ, MORDECHAY
1155 BLOOMFIELD AVENUE
CLIFTON, NJ 07012
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/13/2026 |
|
WELCH, SHIRLEY
SCENIC DRIVE
FREEHOLD, NJ 07728
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2007 |
|
WELLES, ANTONNETTE (CHHA)
124 S. OLDEN AVENUE
TRENTON, NJ 08609
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
4/22/2024 |
WELLS, CHRISTOPHER W. (RPH)
WARRENS WAY
WANAQUE, NJ 07645
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/1/2007 |
|
WELLS, TAMARA (RN)
13 HENRY STREET
BERGENFIELD, NJ 07621
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/8/2018 |
|
WELLS, WARREN (CHHA)
202 BEAR BROOK ACRES DRIVE
MADISON TOWNSHIP, PA 15663
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
WELSH, SETH LOGAN
1852 TRUDEAU DRIVE
FOREST HILL, MD 21050
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/19/2024 |
|
WELWART, ETHAN
6482 RICHBURG HILL ROAD
BOLIVAR, NY 14715
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
4/30/2024 |
|
WELWART, WILLIAM
57 JOSEPH AVENUE
STATEN ISLAND, NY 10314
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
4/30/2024 |
|
WERBIN, MARIS AKA WHITNEY, MARIS (RPH)
126 RIVER DRIVE
LAKE HIAWATHA, NJ 07034
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2006 |
|
WERTHEIM, HOWARD (RPH)
19 KNOB HILL ROAD
HACKETTSTOWN, NJ 07840
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/20/2004 |
|
WERTHEIM, HOWARD (RPH)
696A FRIAR COURT
MANCHESTER, NJ 08759
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/12/2016 |
|
WERTHEIM, MARC (DDS)
24 MERCHANTS WAY P.O. BOX
COLTS NECK, NJ 07722
NPI-1306910427 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
8/25/2009 |
|
WERTHEIM, MARC (DDS)
80 E. JOSEPH STREET
MOONACHIE, NJ 07074
NPI-1306910427 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/20/2013 |
|
WESHNAK, NADIA (RN/LPN)
382 WOOD LAKE MANOR DR.
LAKEWOOD, NJ 08701
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2002 |
|
WESLEY, JOSEPH W. (MD)
246 N FRANKLIN TPK
RAMSEY, NJ 07446
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/19/2002 |
|
WESLEY, LACHAW'YA (CHHA)
732 OCEAN AVENUEM APT. 11
LONG BRANCH, NJ 07740
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/18/2017 |
|
WESLEY, NUEDAH
10 ROANOKE COURT
WILLINGBORO, NJ 08046
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
5/28/2013 |
|
WESTON, MARC (OD)
16 BARNETT ROAD
LAWRENCEVILLE, NJ 08648
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
WHARTON, AMANDA aka AMANDA HIENKEL (LPN)
601 HOWLAND AVENUE
NORTH CAPE MAY, NJ 08204
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/17/2022 |
|
WHETSTONE, RHONDA (CHHA)
73 PEABODY PLACE
NEWARK, NJ 07104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/27/2017 |
|
WHITE, CAMEO (CHHA)
493 SUMMERS STREET, #1
PATERSON, NJ 07501
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/9/2018 |
|
WHITE, MEGHAN AKA MCLEOD, MEGHAN (CHHA)
271 SERPENTINE DRIVE
BAYVILLE, NJ 08721
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/8/2019 |
|
WHITE, PHAEDRA J. (RN)
1107 N SALINA ST. #2
SYRACUSE, NY 132082
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
11/20/2008 |
Permanent |
WHITE, WAYNE (RPH)
11001 NORTHWEST 17TH AVENUE
MIAMI, FL 33167
NPI-1366717514 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
WHITE, WENDELL (CHHA)
106B CHAUCER ROAD
MOUNT LAUREL, NJ 08054
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/25/2003 |
|
WHITEHEAD, TARCHEEKA (CHHA)
1751 OLIVER STREET
RAHWAY, NJ 07065
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
WHITEMAN, GERALD J. (DDS)
RIVERGATE WAY
LONG BRANCH, NJ 07740
NPI-1821191982 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/5/2007 |
8/22/2019 |
WHITEMORE, SHARON T.
51 DOVER ST., 2ND FLOOR
NEWARK, NJ 07106
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/19/2002 |
Permanent |
WHITEMORE, SHARON T.
51 DOVER ST., 2ND FLOOR
NEWARK, NJ 07106
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/15/2005 |
|
WHITNEY, MARIS AKA WERBIN, MARIS (RPH)
126 RIVER DRIVE
LAKE HIAWATHA, NJ 07034
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2006 |
|
WHITTAKER, MICHELLE (CHHA)
801 1/2 4TH AVENUE
NEPTUNE, NJ 07753
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/29/2017 |
2/12/2025 |
WIBLE, BETH (RN)
47 NARCUSSUS LANE
LEVITTOWN, PA 19054
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/22/2019 |
|
WIJETILAKA, ROHAN (MD)
FORT DIX FCI - P.O. BOX 2000
FORT DIX, NJ 08640
NPI-1821058694 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2015 |
|
WIKLINSKI, STEPHEN L. (DC)
C/O DEWOLF ROAD
OLD TAPPAN, NJ 07675
NPI-1659454981 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/18/2001 |
|
WILKING, JULIE (RN)
415B WHITMAN DRIVE
HADDONFIELD, NJ 08033
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2017 |
|
WILKINS, JOHN (DO)
5 ELDERBERRY COURT
MEDFORD, NJ 08055
NPI-1154438786 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/15/2024 |
|
WILKINSON, CHERICE (RN)
809 PASSAIC AVENUE
SEWELL, NJ 08080
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/3/2019 |
|
WILKINSON, PHYLLIS (LPN)
8 WINDING RIDGE COURT
NEPTUNE, NJ 07753
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2006 |
|
WILLARD, VANCE (CHHA)
283 FORD AVENUE
WESTWOOD, NJ 07675
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/25/2018 |
|
WILLER, MAURICE (MD)
631 NYE AVENUE
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/6/2000 |
Permanent |
WILLIAMS JR., OTIS (MD)
106 W. PALISADE AV STE201
ENGLEWOOD, NJ 07631
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/27/1998 |
Permanent |
WILLIAMS JR., OTIS A. (MD)
293 CLASSON AVE., APT 2R
BROOKLYN, NY 11205
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/2/1999 |
Permanent |
WILLIAMS, AMUNDSON C. (LPN)
10 HAAG STREET, UNIT 8A
SAYREVILLE, NJ 08872
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/4/2025 |
|
WILLIAMS, AMY (CNA)
1126 COLLINS ROAD
CAMDEN, NJ 08104
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/15/2004 |
|
WILLIAMS, ARNISSA
256 1/2 SOUTH 19TH STREET
NEWARK, NJ 07103
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/25/2006 |
Permanent |
WILLIAMS, BEATRICE (CHHA)
37 VIVIAN COURT
HOWELL, NJ 07731
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/22/2002 |
|
WILLIAMS, BIANCO (CNA)
3139 SAUNDERS STREET
CAMDEN, NJ 08105
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/1/2022 |
Permanent |
WILLIAMS, CONRAD D. (MD)
255 EASTERN PARKWAY APT A16
BROOKLYN, NY 11238
NPI-1841410701 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2015 |
|
WILLIAMS, CRAIG (DMD)
175 CROSS KEYS ROAD
BERLIN, NJ 08009
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/18/2007 |
|
WILLIAMS, DENEESHAH (CHHA)
133 WILLIAM STREET
ROSELLE, NJ 07203
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
WILLIAMS, DESHAWNA (CHHA)
112 CORAL STREET
PATERSON, NJ 07522
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/26/2017 |
|
WILLIAMS, DIONE (MD)
1787 SPRINGFIELD AVENUE
MAPLEWOOD, NJ 07040
NPI-1356437693 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/16/2015 |
|
WILLIAMS, HELIEN
29 STRATFORD PLACE, APT2F
NEWARK, NJ 07104
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/26/2013 |
|
WILLIAMS, JAMES (THERAPIST)
208 NORTH CHESTNUT STREET
SCOTTDALE, PA 15683
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
WILLIAMS, JEWEL (CHHA)
944 MORTON STREET
CAMDEN, NJ 08105
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
9/23/2014 |
|
WILLIAMS, JONKEMIA (CHHA)
7 MELLON STREET
TRENTON, NJ 08618
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
WILLIAMS, MARCUS (MD)
1500 LOCUST STREET, APT. 3912
PHILADELPHIA, PA 19102
NPI-1619057734 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
WILLIAMS, MARCUS REY
129 FLINTLOCK ROAD
KING OF PRUSSIA, PA 19406
NPI-1619057734 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2024 |
|
WILLIAMS, MECCA (CHHA)
126 PARKER STREET
NEWARK, NJ 07104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
WILLIAMS, VINETTIA
418 SASSAFRAS STREET
MILLVILLE, NJ 08360
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2006 |
|
WILLIAMS-KLENA, JOAN
103 KOMORN ST
NEWARK, NJ 07105
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/17/1987 |
Permanent |
WILLIAMSKY, AARON a/k/a NEIL JOHN AARON WILLIAMSKY
103 BUCKLEY ROAD
MARLBORO, NJ 07746
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/8/2024 |
|
WILLIAMSKY, NEIL JOHN AARON a/k/a AARON WILLIAMSKY
103 BUCKLEY ROAD
MARLBORO, NJ 07746
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/8/2024 |
|
WILLIAMSON, HELEN
41 ATLANTIC AVENUE
MANAHAWKIN, NJ 08050
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/20/2008 |
|
WILLS, LAURA (LPN)
14 E. WIND TRAIL, #22
FAIRFIELD, PA 17320
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
WILSHIRE, GILBERT (MD)
1120 ROUTE 22 E
BRIDGEWATER, NJ 08807
NPI-1386679298 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/3/1999 |
Permanent |
WILSON III, FRANKIE M.
395 NORTH GROVE STREET
EAST ORANGE, NJ 07017
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
11/24/2007 |
|
WILSON, ELLEN (RN/APN)
42 THEO COURT
BURLINGTON, NJ 08016
NPI-1144406620 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
10/27/2017 |
WILSON, EVELYN (LCSW)
209 W. HUDSON AVENUE
ENGLEWOOD, NJ 07631
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/15/2007 |
|
WILSON, IAN
724 GROVE ST
IRVINGTON, NJ 07111
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/24/1985 |
Permanent |
WILSON, JEAN (APN)
2210 PARKSIDE DRIVE
MITCHELLVILLE, MD 20721
NPI-1740568450 |
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/10/2024 |
|
WILSON, REINALDO
125 SAINT CATHERINE CIRCLE
RICHMOND HILL, GA 31324
NPI- |
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/10/2024 |
|
WILSON, TAKEALA (CHHA)
135 BERGEN AVENUE, APT. 2-E
JERSEY CITY, NJ 07305
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/7/2017 |
|
WILSON, TASHA (CHHA)
124 YORK ST., APT.64
SALEM, NJ 08079
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/6/2006 |
|
WILTSEY, JEANNINE (RN)
237 LUCAN LN, APT 11
VOORHEES, NJ 08043
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/9/2023 |
|
WILTSHIRE, CHERIE M. aka MESSINA, CHERIE (LPN)
23 LILAC LANE
LEVITTOWN, PA 19054
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/25/2023 |
|
WINDMILLER, EDWARD (DDS)
3731 WALNUT STREET, APT. A
HARRISBURG, PA 17109
NPI-1871914036 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2015 |
|
WINEGARDEN, ROBERT F. (DMD)
1 ROUTE 27, PARSONAGE RD
EDISON, NJ 08820
NPI-1306056981 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/1999 |
|
WINEGRAD, ALBERT (MD)
3220 LENAPE DRIVE
DRESHER, PA 19025
NPI-1972752855 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
WINTER, JESSICA (CHHA)
426 CATHERINE STREET
BERGENFIELD, NJ 07621
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
WINTHER-GALIMORE, BETHANY
1152 W. US HIGHWAY 54
CAMDENTON, MO 65020
NPI-1134140601 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2011 |
11/13/2023 |
WISCH, GLENN R. (DMD)
6-05 SADDLE RIVER ROAD
FAIRLAWN, NJ 07410
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/29/1996 |
Permanent |
WISE, IESHA (CHHA)
3179 ROSEDALE AVENUE
CAMDEN, NJ 08105
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/5/2019 |
|
WITEK JR., JOSEPH T. (MD)
3625 AVENIDA MADEIRA
BRADENTON, FL 34210
NPI-1063606838 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/17/2000 |
Permanent |
WITHERSPOON, STANTON A. (LPN)
200 MILL ROAD
BURLINGTON, NJ 08016
NPI-1588964316 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2024 |
|
WITHINGTON, PAMELA (RN)
5 CHERRYVILLE ROAD
FLEMINGTON, NJ 08822
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/20/2005 |
|
WITMAN, LEEANN
SCI CAMBRIDGE SPRINGS, 451 FULLERTON AVENUE
CAMBRIDGE SPRINGS, PA 16403
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
WIXNER, PAIGE (LPN)
364 LUANE ROAD
TOMS RIVER, NJ 08755
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/30/2023 |
|
WOLF, JEFFREY A. (DPM)
1100 CLIFTON AVENUE
CLIFTON, NJ 07103
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/14/1997 |
Permanent |
WOLFE, JOSEPH
ROUTE 24
MENDHAM, NJ 07945
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/1/1993 |
Permanent |
WOLFE, MARY (LPN)
2760 PINE GROVE RD.
YORK, PA 17403
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
WOLFE, PATRICK
530 LILLIAN DRIVE
MADEIRA BEACH, FL 33708
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/20/2022 |
|
WOLFE, WILLIAM (MD)
27 ROCKINGHAM DRIVE
MARLTON, NJ 08053
NPI-1003872912 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/12/2016 |
10/18/2019 |
WOLFF, MICHAEL (LPN)
178 WHITES HILL ROAD
ROCHESTER, PA 15074
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2015 |
|
WOLFSON, STANLEY (MD)
5 CLUBWAY LANE
HARTSDALE, NY 10530
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/19/2001 |
|
WOLLMAN, ROBERT (DDS)
461 CENTRAL AVENUE
JERSEY CITY, NJ 07307
NPI-1659429421 |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/6/1987 |
Permanent |
WOMBU, MARIAN UCHE (CHHA)
2225 BENSON AVENUE
BROOKLYN, NY 11214
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/31/2023 |
|
WOOD, FAYE, W. (CHHA)
33 WHITE OAK DRIVE
PRINCETON, NJ 08540
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/25/2002 |
|
WOODS, CALEDA (CHHA)
158 GIRARD AVENUE
TRENTON, NJ 08638
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
WOODSON, BASSEY JUSTICE
32 DAYTON STREET 1B
NEWARK, NJ 07114
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/13/2013 |
11/22/2022 |
WOROSILO, SHARON (MD)
1000 AVENUE OF PORT IMPERIAL
WEEHAWKIN, NJ 07086
NPI-1619965811 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/8/2017 |
|
WOZUNK, GEORGE
1029 E. PARK AVENUE
VINELAND, NJ 08360
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/10/2000 |
|
WREH-TOE, PALLEH
3401 MERLOT COURT
YORK, PA 17404
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2015 |
2/17/2023 |
WREIOLE, AUGUST (DO)
422 MORRIS AVENUE
LONG BRANCH, NJ 07740
NPI-1942247333 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/8/2017 |
6/12/2019 |
WRENN, WALTER F III (MD)
6 PLAYERS LANE
PINE HILL, NJ 08021
NPI-1114023009 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/19/2023 |
|
WRIGHT, CHRISTINE (LPN)
13-B ALPINE ROAD
WHITING, NJ 08759
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/10/2022 |
|
WRIGHT, KIMBERLY A. (RN)
27 GLENSIDE AVENUE
SUMMIT, NJ 07901
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2002 |
|
WRIGHT, LYNN I.
84 PENN STREET
BRIDGETON, NJ 08090
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/17/2008 |
|
WRIGHT, SALLY A. (PSYCH)
GLEN RAY ROAD BOX A
ALDERSON, WV 24910
NPI-1497769160 |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
9/19/2011 |
|
WRIGHT, SANDRA (CHHA)
4938 NORTH 8TH STREET
PHILADELPHIA, PA 19120
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
WRIGHT, SHELLY L. (RN)
MURTLAND STREET
SPRINGDALE, PA 15144
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/23/2007 |
|
WRIGHT, SHONEYEH
CLINTON AVENUE
IRVINGTON, NJ 07111
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
10/5/2007 |
|
WRIGHT, SYDNEY (CHHA)
111 SHERWOOD AVENUE
MAHWAH, NJ 07430
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/18/2017 |
7/12/2022 |
WUJACK, ALLISON (LPN)
308A SUNRISE BOULEVARD
FORKED RIVER, NJ 08731
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/2017 |
|
WYLES, KIMBERLY (CHHA)
116 BLACKWOOD-CLEMENTON ROAD
CLEMONTON, NJ 08021
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/5/2018 |
|
WYLIE, JOHN D. (RPH)
7306 WOODVIEW WAY
MALVERN, PA 19355
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/20/2004 |
|
YAEGER, CHARLES
BARKALOW AVENUE
FREEHOLD, NJ 07728
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/5/2008 |
|
YAEGER, HOPE W. (RN)
1316 S. 10TH ST, APT 2
ALLENTOWN, PA 18103
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2001 |
1/5/2018 |
YAHAV, ERIC (MD)
1720 DEVONSHIRE ROAD
DRESHER, PA 19025
NPI-1013156686 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/1/2020 |
5/6/2021 |
YAISH, ELAN
265 SUNRISE HIGHWAY, SUITE 1-315
ROCKVILLE CENTER, NY 11570
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/28/2024 |
|
YAISH, ELAN
FCI OTISVILLE, PO BOX 1000
OTISVILLE, NY 10963
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/20/2024 |
|
YAKHNIS, ANNA (RN)
28 SAINT MICHAELS COURT
CHURCHVILLE, PA 18966
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
YAKUSHEVA, NADIA a/k/a NADA LEVIT
25 PRIDES LANE
ENGLISHTOWN, NJ 07726
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/8/2024 |
|
YALE, DONNA APPEL (LPN)
49 ANGEL INN TRAILER CRT
FARMINGDALE, NJ 07727
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2000 |
|
YANGBEM PATIENCE (CHHA)
730 FRANKLIN STREET
TRENTON, NJ 08610
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
YATES,N QIANNA (CHHA)
209 EUTAW STREET
CAMDEN, NJ 08105
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/19/2018 |
|
YAW, GAYFORD
504 STEVENS ROAD
LANDING, NJ 07050
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/20/2008 |
|
YAW, GAYFORD A.
504 STEVENS ROAD
LANDING, NJ 07850
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/24/2008 |
|
YEHIA, SAFAA (CHHA)
60 GLENWOOD AVENUE
JERSEY CITY, NJ 07306
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/4/2023 |
|
YELCICK, JOHN (MD)
635 WILLOW GREEN
LITITZ, PA 17543
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/28/2014 |
|
YEN, YA-TANG (MD)
2 FAWN PATH
HOLMDEL, NJ 07733
NPI-1952374530 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/21/2019 |
Permanent |
YEPES, LINA (CHHA)
2105 NEW YORK AVENUE, BSMT 3
UNION CITY, NJ 07087
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
YEPES-SANCHEZ, ONAIDA (CHHA)
1815 PALLISADE AVENUE
UNION CITY, NJ 07086
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
YOON, TOL UNG (MD)
9 MALAGA DRIVE
BRIDGETON, NJ 08302
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
YOUNG, JULIA (CHHA)
2019 SOUTH 9TH STREET
CAMDEN, NJ 08104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
YOUNGER, ANTHONY
65 MAIDEN LANE
LITTLE FERRY , NJ 07643
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
10/15/2008 |
|
YULE, ROBERT C. (RN)
323 FLORENCE ROAD
MIDDLETOWN, NJ 07748
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2003 |
|
YUNATANOV, STEVE (DDS)
83-83 118 TH STREET
KEW GARDENS, NY 11415
NPI-1366749962 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/20/2004 |
|
ZAINELABDIN, AMID
126 CORBIN AVENUE
JERSEY CITY, NJ 07306
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/21/2002 |
|
DELPHI INVALID COACH
1473 RIDGEWAY STREET
UNION, NJ 07083ZAK, FELIX
825 E. 9TH STREET
BROOKLYN, NY 11230
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/9/2001 |
Permanent |
ZAMAN, TANVIR (PHARM TECH)
205 DAVIS AVENUE
ABSECON, NJ 08201
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/18/2018 |
|
F & L MEDICAL TRANS., INC.
1474 RIDGEWAY STREET
UNION, NJ 07083ZAMLOOT, PHILIP
150 PARK ROW
NEW YORK, NY 10007
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/20/2005 |
|
ZANDLER, GUY (RN)
3406 HUDSON AVENUE
UNION CITY, NJ 07087
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
2/8/2024 |
|
ZAPPALA, RICHARD
13 RIDGEWOOD COURT
NORTHFIELD, NJ 08225
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/31/2023 |
|
ZAPPALA, RICHARD ANTHONY
13 RIDGEWOOD COURT
NORTHFIELD, NJ 08225
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2024 |
|
ZARETZKY, SAMANTHA
30 DAWES WAY
LANDING, NJ 07850
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/22/2023 |
|
ZARRELLI, MICHAEL #67206-050
FCI FORT DIX, PO BOX 2000
JOINT BASE MDL., NJ 08640
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/29/2017 |
|
ZASLOW, LAWRENCE
323 SOCIETY HILL BLVD., APT 1
CHERRY HILL, NJ 08003
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/25/2016 |
|
ZAWAHIR, MEEYAPILLAI
91 KNICKERBOCKER ROAD
TENAGLY, NJ 07670
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/20/2006 |
|
ZAWAWI, ADNAN (MD)
154 ENFORD ROAD, APT 304
CAMP HILL, NJ 17011
NPI-1477538742 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/21/2022 |
|
ZELTSER, LAZAR
2333 MORRIS AVE, UNIT D3
UNION, NJ 07083
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/22/1998 |
|
L & Z TRANSPORTATION, INC
6 PLEASANT VALLEY WAY
WEST ORANGE, NJ 07094ZELTSER, RAISA
6 PLEASANT VALLEY WAY
WEST ORANGE, NJ 07079
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
9/14/2000 |
|
ZERKTI, HOUDA (CHHA)
72 KENNEDY BOULEVARD
BAYONNE, NJ 07002
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/8/2017 |
|
ZHAO, MENGJIA (MD)
1831 YATES AVENUE
BRONX, NY 10461
NPI-1871523852 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/20/2016 |
|
ZIBDIE, YOUSEF (MD)
163 WEBSTER DRIVE
WAYNE, NJ 07470
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2018 |
12/18/2023 |
ZIBDIE, YOUSEF (MD)
163 WEBSTER DRIVE
WAYNE, NJ 07470
NPI- |
Medical
Antitrust/Anti-Kickback Acts |
Debarment Human Services
Medical Assistance (Medicaid) |
12/11/2017 |
12/18/2023 |
ZIELKE, ANDRZEJ KAZIMIERZ (MD)
3207 FOX RUN ROAD
ALLISON PARK, PA 15101
NPI-1710929609 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/2022 |
|
ZIHALA, TERESA (RN)
148 MAIN STREET
SPOTSWOOD, NJ 08884
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
9/19/2003 |
|
ZIMMERMAN, DANIEL J. (MD)
51 ROCKLEDGE ROAD
HAWTHORNE, NJ 07506
NPI-1801919741 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/7/1999 |
9/5/2012 |
ZIMMERMAN, DANIEL J. (MD)
501 BARCLAY WALK
CHERRY HILL, NJ 08034
NPI-1801919741 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/23/2016 |
|
ZIMNA, GRAZYNA (CHHA)
19 NEW JERSEY AVENUE
CARTERET, NJ 07008
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2017 |
|
ZOIS, ELIA
P.O.BOX 334
BRIELLE, NJ 08730
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/5/2025 |
|
ZUBAIR, SAIRA
18 RAVENSWOOD LAKE
SCOTCH PLAINS, NJ 07076
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
8/1/2017 |
|
ZUBERI, REHAN
144-09 LABURNUM AVENUE
FLUSHING, NY 11355
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
2/18/1999 |
11/17/2011 |
ZUBERI, REHAN #000188813C
MID-STATE CORRECTIONAL FACILITY, PO BOX 866
WRIGHTSTOWN, NJ 08562
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/28/2018 |
Permanent |
ZUCKERMAN, DAVID H. (DPM)
1803 COUNTRY CLUB DRIVE
CHERRY HILL, NJ 08003
NPI-1124024435 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/20/2012 |
|
ZUCKERMAN, DAVID H. (DPM)
341 S. EVERGREEN AVENUE
WOODBURY, NJ 08096
NPI-1124024435 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/15/2012 |
|
ZUNIGA, GUISELLA (CHHA)
74B WEST SECOND STREET
BOUND BROOK, NJ 08805
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/8/2018 |
Permanent |
ZWIERCAN, ANDREW (RPH)
601 BERGEN STREET
SOUTH PLAINFIELD, NJ 07080
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/20/2016 |
|
1450 ASSOCIATES, LLC dba CENTER FOR DIAGNOSTIC IMAGING
1450 E. CHESTNUT AVENUE, BLDG 4
VINELAND, NJ 08361
NPI-1083660179 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/1/2024 |
Permanent |
2258 PHARMACY, INC.
2258 THIRD AVE.
NEW YORK, NY 10035
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/20/2003 |
|
6522 VENTNOR AVE. PHARMACY, INC.
6522 VENTNOR AVE.
VENTNOR, NJ 08406
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
ABOODS MEDICAL LIVERY
64 BEVAN STREET
JERSEY CITY, NJ 07306
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/22/1994 |
Permanent |
AC HOME NURSING SERVICES
2921 YOUNGSTOWN ROAD
WARREN, OH 44484
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
ACADIAN DIAGNOSTIC LABORATORIES
11842 JUSTICE AVENUE
BATON ROUGE, LA 70816
NPI-1316370950 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/22/2020 |
|
ADAM MEDICAL EQUIPMENT INC. d/b/a ADAM MEDICAL EQUIPMENT
7215 CORPORATE COURT, SUITE 201
FREDERICK, MD 21703
NPI-1538333422 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
9/19/2024 |
|
AIMS DIAGNOSTIC IMAGING SERVICES OF NEW JERSEY
1109 BEACON AVENUE
MANAHAWKIN, NJ 08050
NPI-1710931852 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/18/2023 |
|
ALCALA PHARMACEUTICAL, INC.
3703 CAMINO DEL RIO SOUTH, SUITE 100A
SAN DIEGO, CA 92108
NPI-1255656153 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/4/2023 |
|
ALIGN BACK BELT COMPANY
1875 ROUTE 88 E, SUITE 2
BRICK, NJ 08724
NPI-1093123655 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/8/2024 |
|
ALL AMERICAN MEDICAL SUPPLIES, INC.
641 EAST VENICE AVE
VENICE, FL 34285
NPI-1972744431 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/2024 |
|
ALL AMERICAN MEDICAL SUPPLIES, LLC
7261 SHERIDAN STREET, SUITE 310
HOLLYWOOD, FL 33024
NPI-1073935862 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/2024 |
|
ALL AMERICAN MEDICAL SUPPLIES, LLC
719 DURHAM ROAD
RIEGELSVILLE, PA 18077
NPI-1700208592 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/2024 |
|
ALLCARE PHARMACY, LLC
590 AVENUE C
BAYONNE, NJ 07002
NPI-1386034726 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/19/2024 |
Permanent |
ALLIANCE MEDICAL GROUP, PC
137 MOUNTAIN AVENUE
HACKETTSTOWN, NJ 07840
NPI-1952465569 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/2022 |
|
ALLIED CLINICAL LAB, INC.
5199 S. GREEN STREET
SALT LAKE CITY, UT 84123
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/18/1997 |
Permanent |
ALLIED CLINICAL LAB., INC
863 MCCALLIE AVE.
CHATTANOOGA, TN
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/18/1997 |
Permanent |
ALLSTATE AMBULANCE CORP
PO BOX 1011
UNION, NJ 07083
NPI- |
Medical
Poor Performance |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
AMANA MEDICAL GROUP, INC.
871 MCBRIDE AVENUE, SUITE 1
WOODLAND PARK, NJ 07424
NPI-1548215411 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2018 |
|
AMERICAN EXPRESS LOAN, INC.
13420 DAMAR DRIVE, SUITE C
PHILADELPHIA, PA 19116
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
AMERICAN MED. TECH. INC.
1072 MADISON AVENUE
LAKEWOOD, NJ 08701
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/14/1999 |
Permanent |
AMERICAN MEDICAL EXPRESS
PO BOX 3093
WARMINSTER, PA 18974
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
AMIR FRIEDMAN MD PC
6928 PESCADO CIRCLE #5
RANCHO MURIETA, CA 95683
NPI-1447303623 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/15/2022 |
|
APOGEE BIO-PHARM LLC
180 RARITAN CENTER PARKWAY, SUITE 101
EDISON, NJ 08837
NPI-1427323534 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
4/30/2024 |
|
ARAMINGO PHARMACY
2313 E. VENANGO STREET, SUITE 1A
PHILADELPHIA, PA 19134
NPI-1164994307 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/2024 |
|
AVON PHARMACY
300 MAIN STREET
AVON, NJ 07717
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
2/5/2003 |
|
BAM HEALTHCARE ABERDEEN, LLC dba ABERDEEN PHARMACY
8276 S. JOG ROAD
BOYNTON BEACH, FL 33472
NPI-1629383278 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/28/2024 |
|
BAM HEALTHCARE LVIC, LLC
8930 W. SUNSET ROAD, SUITE 100
LAS VEGAS, NV 89148
NPI-1518527431 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/28/2024 |
|
BEACON MEDICAL MARKETING LLC
57 JOSEPH AVENUE
STATEN ISLAND, NY 10314
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
4/30/2024 |
|
BELMAR HOMETOWN PHARMACY
911 MAIN STREET
BELMAR, NJ 07719
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
2/5/2003 |
|
BENTLEY MEDICAL PLLC
69 COUNTY ROAD 516
OLD BRIDGE, NJ 08857
NPI-1790919140 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/15/2021 |
|
BERGEN ALLIANCE COUNSELING SERVICES LLC
362 MIDLAND AVENUE, 2ND FLOOR
GARFIELD, NJ 07026
NPI-1619297116 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/31/2024 |
|
BERKS PSYCHIATRY
146 SOUTH 5TH STREET
READING , PA 19602
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
BEST MED SUPPLY
617 HILLTOP DRIVE APT B9
TRENTON, NJ 08620
NPI-1568972636 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/31/2023 |
|
BIODIAGNOSTIC LAB SERVICES, INC.
181 NEW STREET SUITE 307
PARSIPPANY, NJ 07054
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
1/21/2015 |
|
BIO-SCIENCE LAB., INC.
1000 WOOODBRIDGE CTR ST140
WOODBRIDGE, NJ 07095
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
3/20/2000 |
Permanent |
BLOOMFIELD PHARMACY, INC.
154 BLOOMFIELD AVENUE
NEWARK, NJ 07104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/31/2000 |
|
BMA MEDICAL LABORATORY
59-07 71ST AVENUE
RIDGEWOOD, NY 11385
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2003 |
|
BRACEWORKS PROF ORTHO(DO)NT
288 HIGHWAY 35 SOUTH
EATONTOWN, NJ 07724
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2003 |
|
BROADWAY HEALTHCARE MANAGEMENT, LLC
218 ROUTE 17 N., SUITE 410
ROCHELLE PARK, NJ 07662
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/10/2025 |
|
BROADWAY HEALTHCARE MANAGEMENT, LLC
218 ROUTE 17 N., SUITE 410
ROCHELLE PARK, NJ 07662
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/10/2025 |
|
BROADWAY HEALTHCARE MANAGEMENT, LLC
218 ROUTE 17 NORTH
ROCHELLE PARK, NY 07662
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2025 |
|
BROADWAY MEDICAL GROUP
227 BROADWAY
PATERSON, NJ 07501
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
BROADWAY NUTRITIONAL SERVICES, LLC
218 ROUTE 17 N., SUITE 410
ROCHELLE PARK, NJ 07662
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/10/2025 |
|
BROADWAY NUTRITIONAL SERVICES, LLC
218 ROUTE 17 N., SUITE 410
ROCHELLE PARK, NJ 07662
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/10/2025 |
|
BROADWAY NUTRITIONAL SERVICES, LLC
218 ROUTE 17 NORTH
ROCHELLE PARK, NY 07662
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2025 |
|
CARDIOLOGY CENTER OF NEW JERSEY, LLC
32 CHELSEA DRIVE
LIVINGSTON, NJ 07039
NPI-260849555 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/25/2023 |
|
CAREPOINT MEDICAL
4860 COX ROAD, SUITE 300
GLEN ALLEN, PA 23060
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
CENTERS AGENCY LLC d/b/a CENTERS LABORATORY
1412 BAYRIDGE AVENUE
BROOKLYN, NY 11219
NPI-1508326851 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/11/2024 |
|
CENTERS LAB NJ LLC d/b/a MEDLABS DIAGNOSTICS
85 HORSE HILL ROAD
CEDAR KNOLLS, NJ 07927
NPI-1598315574 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/12/2024 |
|
CENTRAL DIAGNOSTICS LAB
256 SMITH STREET
PERTH AMBOY, NJ 08861
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/8/1989 |
Permanent |
CENTRAL JERSEY MENTAL CTR
525 PARK AVENUE
PLAINFIELD, NJ 07067
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
CHILDREN'S DENTAL CENTER
3700 KENNEDY BOULEVARD
UNION CITY, NJ 07087
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
9/15/2017 |
|
CITILAB CORPORATION
333 NORTH BROAD STREET
ELIZABETH, NJ 07028
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
|
CLIFTON ORTHOPEDIC ASSOCIATES d/b/a MEGARIOTIS MD PA
1450 MAIN AVENUE
CLIFTON, NJ 07011
NPI-1508130444 |
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/19/2024 |
Permanent |
CLINICAL PSYCHIATRY CONSULTANTS, P.C.
642 DAKOTA TRAIL
FRANKLIN LAKES, NJ 07417
NPI-1407972755 |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
5/22/2024 |
|
CLIN-PATH LABORATORY, INC
626 N. 38TH STREET
BELLEVILLE, IL 62223
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/4/1997 |
Permanent |
COHOME INC.
45 S. PARK PLACE, SUITE 8
MORRISTOWN, NJ 07960
NPI-1619536448 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2025 |
|
COOPER STREET PSYCHIATRIC GRP
301 COOPER STREET
CAMDEN, NJ 08102
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/2/1990 |
Permanent |
DITA, INC.
500 ORANGE STREET
NEWARK, NJ 07104
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/18/1998 |
|
DOSHI DIAGNOSTIC IMAGING
,
NPI- |
Other |
|
|
|
SERVICES OF NEW JERSEY, LLC
434 NEW JERSEY AVE
ABSECON, NJ 08201
NPI-1710931852 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/15/2021 |
|
DOWNTOWN DENTAL CENTER PA
1 WEST BROADWAY
PATERSON, NJ 07505
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/20/2001 |
Permanent |
DUNN MEADOW PHARMACY
1555 CENTER AVENUE, FIRST FLOOR
FORT LEE, NJ 07024
NPI-1508222696 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/3/2022 |
|
EASY DENTAL, PC
5616 GERMANTOWN AVENUE
PHILADELPHIA, PA 19114
NPI-1093093585 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
EGYPTIAN INC.
19015 TOWN CENTER DRIVE
APPLE VALLEY, CA 92308
NPI-1285959007 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/15/2021 |
|
EL MEDICAL, INC.
9105C OWENS DRIVE
MANASSAS PARK, VA 20111
NPI-1295049815 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/24/2021 |
|
ELEVATEABILITY LLC
901 ROUTE 23 SOUTH
POMPTON PLAINS, NJ 07444
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2025 |
|
ELITE PHARMACY, INC. d/b/a ELITE PHARMACY
222 N. WOOD AVENUE
LINDEN , NJ 07036
NPI-1992379960 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/5/2025 |
|
FAMILY ENRICHMENT INSTIT.
415 KEIM BOULEVARD
BURLINGTON, NJ 08016
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/1999 |
|
FINE-TRANS MEDICAL TRANS
2824 KENNEDY BLVD. #465
JERSEY CITY, NJ 07306
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/14/1994 |
Permanent |
FINLAY MEDICAL LABORATORY
4912 BERGENLINE AVENUE
WEST NEW YORK, NJ 07093
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/14/1998 |
Permanent |
FIRESPIRIT INC.
6612 TERRA DOLCE AVE, NW
ALBUQUERQUE, NM 87114-1365
NPI- |
Medical
Antitrust/Anti-Kickback Acts |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/23/2011 |
|
FRANKLIN MEDICAL ASSOC
14 FRANKLIN STREET
BELLEVILLE, NJ 07109
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/15/1999 |
Permanent |
GEORGIA LUNG ASSOCIATES
3820 MEDICAL PARK AVENUE
AUSTELL, GA 30106
NPI-1104989136 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2015 |
|
GERISCRIPT SUPPLIES, LLC
1 UNIVERSITY PLAZA, SUITE 206
HACKENSACK, NJ 07601
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/10/2025 |
|
GERISCRIPT SUPPLIES, LLC
1 UNIVERSITY PLAZA, SUITE 206
HACKENSACK, NJ 07601
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/10/2025 |
|
GERISCRIPT SUPPLIES, LLC
1 UNIVERSITY PLAZA, SUITE 206
HACKENSACK, NJ 07601
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2025 |
|
GOLDEN HEALTHCARE LLC dba GOLDEN HEALTHCARE PHARMACY
242 PALISADE AVE., SUITE A
GARFIELD, NJ 07026
NPI-1427479344 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
2/23/2024 |
|
GOLDIS GERIATRICS P.C.
119 EAST LAUREL ROAD
STRATFORD, NJ 08084
NPI-1194921650 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/15/2021 |
|
GREENTOWN MEDICAL ASSOCIATES a/k/a GREENTOWN MEDICAL CENTER
1623 ROUTE 507
GREENTOWN, PA 18426
NPI-1396837035 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/20/2024 |
|
H.W. WEIDCO/STER LLC d/b/a STERLING MANOR NURSING CENTER
794 N. FORKLANDING ROAD
MAPLE SHADE, NJ 08052
NPI-1699783910 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/10/2025 |
|
H.W. WEIDCO/STER LLC d/b/a STERLING MANOR NURSING CENTER
794 N. FORKLANDING ROAD
MAPLE SHADE, NJ 08052
NPI-1699783910 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/10/2025 |
|
H.W. WEIDCO/STER LLC d/b/a STERLING MANOR NURSING CENTER
794 N. FORKLANDING ROAD
MAPLE SHADE, NJ 08052
NPI-1699783910 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2025 |
|
HASHIM'S MEDICAL LIVERY
P. O. BOX 930
NEW YORK, NY 10013
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/26/1994 |
Permanent |
HEALTH PHARMACY INC
3 POND RD
PARSIPPANY, NJ 07054
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
HHCH HEALTH CARE C/O IRINA KRUTOYARSKY
ALDERSON FEDERAL CAMP, GLEN RAY ROAD, BOX A
ALDERSON, WV 24910
NPI-1639294812 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/24/2017 |
|
HOME CARE SOLUTIONS
16 COMMERCE DRIVE
CRANFORD, NJ 07016
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
1/24/2014 |
|
HYPE MED, LLC
801 ANDREWS AVENUE, APT 3
DELRAY BEACH, FL 33483
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
5/9/2024 |
|
I & I INVALID COACH, INC. D/B/A READY CARE CORPORATION
85 CENTRAL AVENUE
CLIFTON, NJ 07015
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/19/2004 |
|
INCLINE HEALTH, LLC
1075 STEPHENSON AVE, SUITE D
OCEANPORT, NJ 07757
NPI-1306207659 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/28/2024 |
|
INFINITE CARE
6423 RISING SUN AVENUE
PHILADELPHIA, PA 19111
NPI-1073549671 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2015 |
|
INTEGRITY HOME VISITS, INC.
418 BROADWAY, 2ND FLOOR
BAYONNE, NJ 385085
NPI-1871928234 |
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/10/2024 |
|
J & S PHARMACY, INC.
214 SECOND STREET
ELIZABETH, NJ 07207
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/11/1997 |
|
J & S PHARMACY, INC.
214 SECOND STREET
ELIZABETH, NJ 07207
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
J.S. AMIN MD PA
355 HENRY STREET
ORANGE, NJ 07050
NPI-1538388970 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/20/2024 |
|
JACKSON SURGICAL CENTER, LLC
27 S. COOKS BRIDGE ROAD, STE. L2
JACKSON, NJ 08527
NPI-1275930216 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/25/2023 |
|
JAIME BROTHERS, LLC d/b/a FABIO'S PHARMACY
88 MARKET STREET
PATERSON, NJ 07505
NPI-1649693557 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/17/2026 |
|
JIMS TRANSPORTATION
49 WESTERN PARKWAY
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/11/2006 |
|
JITAN CARDIOLOGY CORP
2137 HIGHWAY 35
HOLMDEL, NJ 07733
NPI-1720144280 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/15/2022 |
|
JOURNEY SERVICES LLC
45 S. PARK PLACE, SUITE 8
MORRISTOWN, NJ 07960
NPI-1144933904 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2025 |
|
JRMICK, INC.
911 MAIN STREET
BELMAR, NJ 07719
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/16/2005 |
|
KADISHA, INC.
667 MT. PROSPECT AVENUE
NEWARK, NJ 07104
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
5/14/1998 |
|
KBWB OPERATIONS LLC d/b/a ATRIUM HEALTH AND SENIOR LIVING
1120 ALPS ROAD
WAYNE, NJ 07470
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
12/5/2025 |
|
KINGS PHARM
716 MARKET ST
GLOUCESTER, NJ 08030
NPI- |
Medical
Poor Performance |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2004 |
Permanent |
275192651
KWENYAN AND ASSOCIATES
,
NPI-1598196719; 1104260538; 1457878423 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
12/14/2022 |
|
204080824
KWENYAN PROFESSIONAL HEALTH SERVICES, LLC
,
NPI-1003392374; 1205312766; 1285928457; 1629221239; 1609335736 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
12/14/2022 |
|
LAB SOLUTIONS LLC
1451 NORTHSIDE DRIVE, SUITE A
ATLANTA, GA 30318
NPI-1275971707 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/20/2023 |
|
LIFE CARE HOME SERVICES OF NORTHWESTERN PENNSYLVANIA
2127 NORTH 6TH STREET
PHILADELPHIA, PA 19122
NPI-1972641496 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2015 |
|
LIFE SUPPORT CORPORATION
CI MOSHANNON VALLEY, 555 GEO DRIVE
PHILLIPSBURG, PA 16866
NPI-1659699049 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/29/2015 |
|
LIVSHITZ PHARMACY INC
203 16TH AVENUE
NEWARK, NJ 07103
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/21/1980 |
Permanent |
M & G LIVERY CO. INC.
6 PLEASANT VALLEY WAY
WEST ORANGE, NJ 08052
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/19/2003 |
|
M & G TRANSPORTATION & LIVERY
269 SHEFFIELD STREET
MOUNTAINSIDE, NJ 07092
NPI- |
Medical
Criminal Offense |
Debarment Human Services
Medical Assistance (Medicaid) |
10/31/2002 |
|
M & M MEDICAL LIVERY
64 BEVAN STREET
JERSEY CITY, NJ 07306
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/31/1994 |
Permanent |
M&A/COMPREHENSIVE HEALTH CARE MANAGEMENT SYSTEMS, LLC
1104 TEANECK ROAD
TEANECK, NJ 07666
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/10/2025 |
|
M&A/COMPREHENSIVE HEALTH CARE MANAGEMENT SYSTEMS, LLC
1104 TEANECK ROAD
TEANECK, NJ 07666
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/10/2025 |
|
M&A/COMPREHENSIVE HEALTH CARE MANAGEMENT SYSTEMS, LLC
1104 TEANECK ROAD
TEANECK, NJ 07666
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2025 |
|
MATAWAN-ABERDEEN HEART AND MEDICAL CENTER, P.C. dba MATAWAN-ABERDEEN HEART AND MEDICAL CENTER
177 MAIN STREET
MATAWAN, NJ 07747
NPI-1588997738 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
3/4/2024 |
6/10/2024 |
MATAWAN-ABERDEEN HEART AND MEDICAL CENTER, P.C. dba MATAWAN-ABERDEEN HEART AND MEDICAL CENTER
177 MAIN STREET
MATAWAN, NJ 07747
NPI-1588997738 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/11/2024 |
|
MAZZACCOS PHARMACY INC
427 PROSPECT STREET
LONG BRANCH, NJ 07740
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/27/1983 |
Permanent |
MEDICAL CLINICAL LABOR.
373 LIVINGSTON AVENUE
NEW BRUNSWICK, NJ 08901
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/29/1999 |
Permanent |
MEDICAL GROUP OF NORTH JERSEY, LLC
401 HALEDON AVENUE
HALEDON, NJ 07508
NPI-1114972064 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/12/2023 |
4/10/2024 |
MEDIPATH EXPRESS
666 PLAINSBORO ROAD
PLAINSBORO, NJ 08536
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/14/2005 |
|
MEDISCOPE DIAG. LAB. INC.
1250 PARK AVENUE
PLAINFIELD, NJ 07060
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/16/1998 |
|
METPATH LABORATORIES, INC.
322 US 46, SUITE 160W
PARSIPPANY, NJ 07054
NPI-1174095459 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
5/2/2023 |
|
METRO HEALTH PHARMACY LLC
5543 MYRTLE AVENUE
RIDGEWOOD, NY 11385
NPI-1689951717 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/15/2021 |
|
MILAROLA CORP INC
57 BROADWAY
NEWARK, NJ 07014
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
NASSAU PHARMACY
80 NASSAU STREET
PRINCETON, NJ 08540
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
NATIONAL NUTRITIONAL FOOD COMPANY, LLC
218 ROUTE 17 N., SUITE 410
ROCHELLE PARK, NJ 07662
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/10/2025 |
|
NATIONAL NUTRITIONAL FOOD COMPANY, LLC
218 ROUTE 17 N., SUITE 410
ROCHELLE PARK, NJ 07662
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/10/2025 |
|
NATIONAL NUTRITIONAL FOOD COMPANY, LLC
218 ROUTE 17 NORTH
ROCHELLE PARK, NY 07662
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/20/2025 |
|
NATIONAL SPINE MEDICAL CENTERS PLLC
2103 GOLDEN POND DRIVE
KINGWOOD, TX 77345-1644
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/20/2005 |
|
NIRANJAN MITTAL MD, LLC
201 LOWER NOTCH ROAD, SUITE C2
LITTLE FALLS, NJ 07424
NPI-1194469817 |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
9/25/2024 |
|
NJ GOLDEN HOME CARE CORPORATION
910 BERGEN AVENUE, SUITE 206
JERSEY CITY, NJ 07306
NPI-1851775415 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/5/2024 |
11/11/2025 |
NJ GOLDEN HOME CARE CORPORATION
910 BERGEN AVENUE, SUITE 206
JERSEY CITY, NJ 07306
NPI-1851775415 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/12/2025 |
Permanent |
NOAH ASSOCIATES INC.
4113 N. PORT WASHINGTON ROAD
MILWAUKEE, WI 53212
NPI-1558896498 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/15/2025 |
|
NORA HOME CARE LLC
910 BERGEN AVENUE, SUITE 206
JERSEY CITY, NJ 07306
NPI-1699235978 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/5/2024 |
11/11/2025 |
NORA HOME CARE LLC
910 BERGEN AVENUE, SUITE 206
JERSEY CITY, NJ 07306
NPI-1699235978 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/12/2025 |
Permanent |
NORTH END FAMILY MEDICAL CARE, INC.
644 MOUNT PROSPECT AVENUE
NEWARK, NJ 07104
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2018 |
|
NORTH JERSEY INTERVENTIONAL PAIN CENTER LLC
408 MAIN STREET, SUITE 101 D
BOONTON, NJ 07005
NPI-1801379839 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/15/2025 |
|
NORTH WARREN MEDICAL ASSOCIATES PC
PANTHER VALLEY MALL BLDG B ROUTE 517
HACKETTSTOWN, NJ 07840
NPI-1477641074 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
11/6/2025 |
Permanent |
NORTHGATE COM. PHARMACY
156 COUNTRY FARM RD
MARLTON, NJ 08053
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/6/2006 |
Permanent |
OJAH CORPORATION
42-44 SUSSEX AVENUE
EAST ORANGE, NJ 07018
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/22/2006 |
Permanent |
OLD BRIDGE CENTER OF PHYSICAL THERAPY INC.
77 GARDEN COURT
SAINT AUGUSTINE, FL 32092
NPI-159889479 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/15/2022 |
|
OLEG FRANK MD PC
40 FERRY STREET, STE A
NEWARK, NJ 07105
NPI-1134454549 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/15/2022 |
|
ORANGE COMMUNITY MRI
345 HENRY STREET, STE102
ORANGE, NJ 07055
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
3/16/2012 |
|
OTISMED CORPORATION
1600 HARBOR BAY PARKWAY
ALAMEDA, CA 94502
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/27/2015 |
|
OXFORD DIABETIC SUPPLY, INC.
53 FRONTAGE ROAD, SUITE 100
HAMPTON, NJ 08827
NPI-1700016045 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/8/2016 |
|
PAIN SPECILALISTS, P.A.
1907 NEW ROAD
NORTHFIELD, NJ 08225
NPI-1922161470 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/20/2025 |
|
PARK MEDICAL LABORATORY
298 CLAIRMONT AVENUE
MONTCLAIR, NJ 07042
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/1976 |
Permanent |
PARKWAY CENTRAL PHARMACY
185 CENTRAL AVENUE
EAST ORANGE, NJ 07518
NPI-1285722702 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/28/2022 |
|
593784830
PARTNERS FOR HOPE, PC
365 RIFLE CAMP ROAD, SUITE 201
WOODLAND PARK, NJ 07424
NPI-1689883001 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/17/2019 |
4/24/2019 |
PEOPLE CHOICE HOME CARE
430 MORRIS AVENUE
ELIZABETH, NJ 07208
NPI-1851416069 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/24/2017 |
|
POINTE O' WOODS PHARMACY
999 US HIGHWAY ROUTE 9
HOWELL, NJ 07731
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/11/2000 |
Permanent |
PRECISE MEDICAL LAB., INC
1265 PATERSON PLANK ROAD
SECAUCUS, NJ 07094
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
PREFERRED MEDICAL TRANSPORT INC.
151 DISCOVERY DRIVE, SUITE 108
COLMAR, PA 18915
NPI-1649526559 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/15/2024 |
|
PURSUECARE CONNECTICUT PC
820 BEAR TAVERN ROAD
EWING, NJ 08628
NPI-1003443185 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/15/2024 |
|
PURSUECARE NEW JERSEY PC
1000 WHITE HORSE ROAD, SUITE 502
VOORHEES, NJ 08043
NPI-1851067524 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/15/2024 |
|
QUICK SCRIPT PHARMACY
90 WASHINGTON STREET
EAST ORANGE, NJ 07017
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
9/22/2000 |
|
R & M CORP.
156 COUNTRY FARM RD
MARLTON, NJ 08053
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
RANCOCAS VALLEY ANESTHESI
700 U.S. 130 NORTH
CINNAMINSON, NJ 08077
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/20/2003 |
|
RDx BIOSCIENCE, INC
629 SPRINGFIELD ROAD
KENILSWORTH, NJ 07033
NPI-1073961108 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
3/9/2023 |
|
RECOVERY SYSTEMS INC.
476 CLIFTON AVE.
CLIFTON, NJ 07011
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
5/8/2003 |
|
REDIDOC LLC
221 W. JOMAX ROAD
PHOENIX, AZ 85085
NPI-1750823159 |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/9/2024 |
|
RESTORATION PHARMACY
1385 STUYVESANT AVENUE
UNION, NJ 07083
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
1/16/2009 |
1/6/2012 |
RGN PHARMACY
ELIZABETH AVENUE
NEWARK, NJ 07108
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
8/17/2007 |
|
RX 2000 PHARMACY, INC.
2125A KENNEDY BLVD
JERSEY CITY, NJ 07305
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/2/2000 |
Permanent |
S. RESES APOTHOCARY
6522 VENTNOR AVE.
VENTNOR, NJ 08406
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
SALT & PEPPER INC.
24 BRANFORD PLACE
NEWARK, NJ 07102
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/9/1994 |
Permanent |
SANDFORD'S PHARMACY INC.
128 MAIN ST
MATAWAN, NJ 07747
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/5/1999 |
Permanent |
SARACARE, LLC d/b/a ALL AMERICAN MEDICAL
6600 NW 16TH STREET, SUITE 6
PLANTATION, FL 33313
NPI-1679522205 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/2024 |
|
SCHERING SALES CORPORATION
2000 GALLOPING HILL ROAD
KENILWORTH, NJ 07033
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
10/20/2005 |
Permanent |
SCHNORBUS PHARMACY
351 NORTH WARREN STREET
TRENTON, NJ 08618
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/19/1981 |
Permanent |
SINGER-ANDREINI PHARMACY
5532 BERGENLINE AVENUE
WEST NEW YORK, NJ 07093
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
7/23/1998 |
|
SOUTHERN MED & SURGICAL
2230 S CROSKEY ST
PHILA, PA 19145
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/19/1992 |
Permanent |
SOUTHERN OCEAN PEDIATRICS AND FAMILY MEDICINE
1100 ROUTE 72 WEST, SUITE 304
MANAHAWKIN, NJ 08050
NPI-1346664893 |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
1/27/2017 |
4/27/2017 |
SPECIALTY CLINICAL LAB.
299 ACADEMY STREET
JERSEY CITY, NJ 07306
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
12/1/1998 |
Permanent |
STAT MRI, LLC
1801 NEW ROAD
LINWOOD, NJ 08221
NPI-1558546085 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
7/15/2021 |
|
STATLINE AMBU. & MEDI-COACH
P. O. BOX 2100
WEST PATERSON, NJ 07424
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/15/1987 |
Permanent |
STAVCO, INC.
300 MAIN STREET
AVON, NJ 07717
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/11/2005 |
|
SYMED, INC.
2502 NORTH CLARK STREET SUITE 210
CHICAGO, IL 60614
NPI- |
Medical
Other |
Disqualification Human Services
8/22/1920 |
7/29/2022 |
|
T&N PHARMACEUTICAL CO.INC
90 WASHINGTON STREET
EAST ORANGE, NJ 07017
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
9/22/2000 |
|
TOUCH OF LIFE, LLC
CHELSEA AVENUE
NEWARK, NJ 07106
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
3/9/2008 |
|
TRILOGY DIAGNOSTICS LLC
2263 VALDINA STREET, STE 100
DALLAS, TX 75207
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/15/2022 |
|
TRI-STATE VISITING HOME PHYSICIANS
1303 VETERANS HIGHWAY
BRISTOL, PA 19007
NPI-1245671015 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/20/2022 |
|
UNION CITY DIAGNOSTIC LAB
2201 BERGENLINE AVENUE
UNION CITY, NJ 07007
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
6/10/2001 |
Permanent |
UNITED DENTAL CENTER
35 WALLINGTON AVE
WALLINGTON, NJ 07057
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
9/18/2003 |
|
UNITED DIAGNOSTIC LAB INC.
100 CRAIG ROAD, SUITE 104
MANALAPAN, NJ 07726-8731
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/18/1997 |
|
UNITED PHARMACY
1347 SPRINGFIELD AVENUE
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
7/30/2005 |
|
UNIVERSAL MEDICAL LAB.
43 MOONACHIE ROAD
HACKENSACK, NJ 07601
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
5/10/1999 |
Permanent |
UNIVERSAL MEDICAL TRANSP.
845 BERGEN AVE. #190
JERSEY CITY, NJ 07306
NPI- |
Medical
Industry Law Violation |
Disqualification Human Services
Medical Assistance (Medicaid) |
6/14/1994 |
Permanent |
US CLINICAL LAB., INC.
185 S. EUCLID ST, STE.111
PASADENA, CA 91101
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
4/22/1997 |
Permanent |
US DIAGNOSTIC SERVICES, INC.
185 6TH AVENUE, 2ND FLOOR
PATERSON, NJ 07524
NPI-1649565219 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
10/13/2021 |
|
V.C. LABORATORY, INC.
9 COURTLAND AVENUE
STATEN ISLAND, NY 10301
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/24/2003 |
Permanent |
VALUE-RITE PHARMACY, INC.
350 WEST MARKET STREET
NEWARK, NJ 07107
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
4/29/1997 |
|
VASCULAR ACCESS OF MEMPHIS PLLC
5885 AIRLINE ROAD
ARLINGTON, TN 38002
NPI-1700063930 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
2/11/2021 |
|
VENDETTI CLINICAL LAB INC
904 D OAK TREE ROAD
S. PLAINFIELD, NJ 07080
NPI- |
Medical
Other |
Debarment Human Services
Medical Assistance (Medicaid) |
12/1/1999 |
Permanent |
VICTORY PHARMACY
1238 SPRINGFIELD AVENUE
IRVINGTON, NJ 07111
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
2/1/2008 |
|
WALL PHARMACY
2510 BELMAR BLVD.
WALL, NJ 07719
NPI- |
Medical
Criminal Offense |
Suspension Human Services
Medical Assistance (Medicaid) |
2/5/2003 |
|
WEST ORANGE PHARMACY
443 MAIN STREET
WEST ORANGE, NJ 07052
NPI- |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
3/29/2017 |
Permanent |
WESTFIELD AVE PHARMACY
156 COUNTRY FARM RD
MARLTON, NJ 08053
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
|
Permanent |
WHITE'S HEALTHCARE ENTERPRISES d/b/a WHITE'S PHARMACY
60A SOUTH STREET
MORRISTOWN, NJ 07690
NPI-1407804636 |
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
8/20/2024 |
|
WILMINGTON ISLAND DME, INC. DBA WI MEDICAL
1260 WEST BAY DRIVE, SUITE F
LARGO, FL 33770
NPI-1235362823 |
Medical
Other |
Disqualification Human Services
Medical Assistance (Medicaid) |
4/20/2022 |
|
WINGROVE DRUGS, INC.
634 DR. MARTIN L. KING BV
NEWARK, NJ 07102
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
6/5/1997 |
|
WINKY, INC.
2510 BELMAR BLVD.
WALL, NJ 07719
NPI- |
Medical
Criminal Offense |
Disqualification Human Services
Medical Assistance (Medicaid) |
1/11/2005 |
|
WOUND HEALING ASSOCIATES
203 3111 ROUTE 38 #11
MT. LAUREL, NJ 08054
NPI- |
Medical
Other |
Suspension Human Services
Medical Assistance (Medicaid) |
11/19/2005 |
|
NPI- |
Other |
|
|
|