New Jersey Keystone Physicians,pa
Family Medicine in Ridgewood, NJ. Organization (NPI-2).
Details
- NPI
- 1215123732
- Entity type
- Organization (NPI-2)
- Legal business name
- New Jersey Keystone Physicians,pa
- Organization subpart
- No
- Enumeration date
- Sep 18, 2007
- Last updated
- May 28, 2013
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 25MAO7320300 | NJ | Yes |
Practice location
1200 E Ridgewood AveWest Wing, Second Floor
Ridgewood, NJ 07450-3957
Phone 201-447-3690 · Fax 201-447-3691
Mailing address
Po Box 115Ridgewood, NJ 07451-0115
Phone 201-447-3690 · Fax 201-447-3691
Authorized official
Nicholas Demetrios Panagiotou
Medical Director
2014473690
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