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General NPI Number Information
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NPI Number | 1932112950
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Entity Type | Organization
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Legal Business Name | PATTNER & GRODSTEIN MD PA
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 10/01/2007
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Provider Practice Location Address
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Address Line | 177 N DEAN ST SUITE 207
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-2533
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Country | US
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Telephone | 201-567-0446
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Fax | 201-567-8775
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Provider Business Mailing Address
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Address Line | 177 N DEAN ST SUITE 207
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-2533
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Country | US
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Telephone | 201-567-0446
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Fax | 201-567-8775
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AUSTIN M PATTNER
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Credential | MD
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Telephone | 201-567-0446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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