National Provider Identifier Database

ENNOBLE HC NJ III PC
Geriatric Medicine

A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.


Contact Information

ENNOBLE HC NJ III PC
2 UNIVERSITY PLZ STE 204
HACKENSACK, NJ07601-6211
Phone: 551-295-8223
Fax:
Website:
Specialty Taxonomy Code
* Geriatric Medicine 207QG0300X

* Indicates primary specialty

NPI Profile & details for ENNOBLE HC NJ III PC

NPI Number 1043192099
Legal business name
LBN
ENNOBLE HC NJ III PC
Authorized official MARK BRADSHAW - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 07/22/2025
Last updated 08/29/2025 - About 9 months ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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