Provider Demographics
NPI:1982890422
Name:SCOTT B. POMERANTZ, MD
Entity type:Organization
Organization Name:SCOTT B. POMERANTZ, MD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CLAUDE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAQUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:201-262-5070
Mailing Address - Street 1:523 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-4737
Mailing Address - Country:US
Mailing Address - Phone:201-262-5070
Mailing Address - Fax:201-262-5333
Practice Address - Street 1:523 FOREST AVE
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-4737
Practice Address - Country:US
Practice Address - Phone:201-262-5070
Practice Address - Fax:201-262-5333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ631912Medicare PIN
NJ1239910001Medicare NSC