Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

ENNOBLE HC KY PLLC
NPI 1275469488
Family Medicine - Geriatric Medicine in Hackensack, NJ

Q: What is Ennoble Hc Ky PLLC's NPI number?

The NPI number for Ennoble Hc Ky PLLC is 1275469488. It was assigned to this organization in the NPPES registry on June 23, 2026.

Q: What is Ennoble Hc Ky PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Geriatric Medicine, with taxonomy code 207QG0300X.

Active since June 23, 2026

2 UNIVERSITY PLZ STE 204, HACKENSACK, NJ 07601(551) 295-8223 Get Directions Write a Review

NPPES record added: June 23, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Ennoble Hc Ky Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ENNOBLE HC KY PLLC (NPI 1275469488) is a healthcare organization registered as a geriatric medicine in Hackensack, New Jersey and active in the NPI registry since June 2026. The organization lists Mark Bradshaw, Owner, as its authorized official.

NPPES Registry Identity

NPI1275469488

Entity TypeOrganization

Primary Taxonomy207QG0300X

Legal Business NameENNOBLE HC KY PLLC

Location Address2 UNIVERSITY PLZ STE 204Hackensack, NJ 07601-6211

Mailing Address2 University PlzHackensack, NJ 07601-6202 · (551) 295-8223

Phone(551) 295-8223

Organization SubpartNo

Authorized OfficialMark BradshawOwner · (678) 665-2618

Enumeration DateJune 23, 2026

NPPES CertifiedJune 23, 2026

✔ NPI 1275469488 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QG0300X

Definition

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.

2 UNIVERSITY PLZ STE 204, Hackensack, NJ 07601

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BREEANA DICKSON

Nurse Practitioner