C AND M KINTIROGLOU MD'S PA
NPI 1689969396
Pediatrics - Adolescent Medicine in West Orange, NJ

NPI Status: Active since June 10, 2011

Contact Information

1500 PLEASANT VALLEY WAY
SUITE 301
WEST ORANGE, NJ
ZIP 07052
Phone: (973) 243-0002

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  • Organization
  • Pediatrics
  • Adolescent Medicine
  • CLIA Number: 31D0104674
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 12-22-2026

About C AND M KINTIROGLOU MD'S PA

This page provides the complete NPI Profile along with additional information for C And M Kintiroglou Md's Pa, a pediatrician established in West Orange, New Jersey operating as a Pediatrics, focusing in adolescent medicine . The healthcare provider is registered in the NPI registry with number 1689969396 assigned on June 2011. The practitioner's primary taxonomy code is 2080A0000X with license number 25MA03124000 (NJ). The provider is registered as an organization and their NPI record was last updated 14 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Ms. Brigette Fullard (Office Manager)

NPI
1689969396
Provider Name
C AND M KINTIROGLOU MD'S PA
Entity Type
Organization
Location Address
1500 PLEASANT VALLEY WAY SUITE 301 WEST ORANGE, NJ 07052
Location Phone
(973) 243-0002
Mailing Address
1500 PLEASANT VALLEY WAY SUITE 301 WEST ORANGE, NJ 07052
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-10-2011
Last Update Date
06-10-2011
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A pediatrician like C And M Kintiroglou Md's Pa is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pediatrics Adolescent Medicine

Taxonomy Code
2080A0000X
Type
Allopathic & Osteopathic Physicians
License No.
25MA03124000
License State
NJ
Taxonomy Description
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MS. BRIGETTE FULLARD

Authorized Official Title
OFFICE MANAGER
Authorized Official Phone
(973) 243-0002

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
31D0104674
Facility Type
Physician Office
Certificate Effective Date
December 23, 2024
Certificate Expiration Date
December 22, 2026
Laboratory Director
JOHN KINTIROGLOU
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to C And M Kintiroglou Md's Pa to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1689969396
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2616918618318
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 1 + 6 + 9 + 1 + 8 + 6 + 1 + 8 + 3 + 1 + 8 + 24 = 84
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
90 - 84 = 66

The NPI number 1689969396 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

DR. GARY S FRIEDMAN M.D.

Internal Medicine

(Nephrology)

1500 PLEASANT VALLEY WAY
SUITE 203
WEST ORANGE, NJ
ZIP 07052

(973) 325-8080

STEVEN M. HERTZ MD

Surgery

(Vascular Surgery)

1500 PLEASANT VALLEY WAY
SUITE 302
WEST ORANGE, NJ
ZIP 07052

(973) 324-0988

MARK HOWARD FORMAN MD

Thoracic Surgery (Cardiothoracic Vascular Surgery)

1500 PLEASANT VALLEY WAY
STE 302
WEST ORANGE, NJ
ZIP 07052

(973) 324-0988

DR. LINCOLN MILLER MD

Internal Medicine

(Infectious Disease)

1500 PLEASANT VALLEY WAY
SUITE 201
WEST ORANGE, NJ
ZIP 07052

(973) 966-6400

LINCOLN P MILLER MD LLC

Internal Medicine

(Infectious Disease)

1500 PLEASANT VALLEY WAY
STE 201
WEST ORANGE, NJ
ZIP 07052

(973) 966-6400

DR. RONALD GARY FRANK M.D.

Urology

1500 PLEASANT VALLEY WAY
SUITE 201
WEST ORANGE, NJ
ZIP 07052

(973) 731-6600

DR. HOWARD ALAN HOLTZ M.D.

Internal Medicine

1500 PLEASANT VALLEY WAY
SUITE 205
WEST ORANGE, NJ
ZIP 07052

(973) 669-9797

GARY K BERMAN MD

Internal Medicine

(Cardiovascular Disease)

1500 PLEASANT VALLEY WAY
SUITE 207
WEST ORANGE, NJ
ZIP 07052

(973) 669-0202

DR. ALAN B GERTNER PH.D.

Audiologist

1500 PLEASANT VALLEY WAY
SUITE 206
WEST ORANGE, NJ
ZIP 07052

(973) 325-1155

NEIL KAHANOVITZ M.D.

Orthopaedic Surgery

1500 PLEASANT VALLEY WAY
SUITE 101
WEST ORANGE, NJ
ZIP 07052

(973) 669-5600

BARRY F WACHTLER PTA

Physical Therapy Assistant

1500 PLEASANT VALLEY WAY
SUITE 102
WEST ORANGE, NJ
ZIP 07052

(973) 325-3422

REBECCA H KONSTANDT PT

Physical Therapist

1500 PLEASANT VALLEY WAY
SUITE 102
WEST ORANGE, NJ
ZIP 07052

(973) 325-3422

DR. ERIC MARK JOSEPH MD

Otolaryngology

(Facial Plastic Surgery)

1500 PLEASANT VALLEY WAY
SUITE 206
WEST ORANGE, NJ
ZIP 07052

(973) 325-1155

KRISTINA WALKER PA-C

Orthopaedic Surgery

1500 PLEASANT VALLEY WAY
SUITE 101
WEST ORANGE, NJ
ZIP 07052

(973) 669-5600

MICHELE MILLER

Counselor

(Professional)

1500 PLEASANT VALLEY WAY
SUITE 201
WEST ORANGE, NJ
ZIP 07052

(973) 819-8564

DR. GEORGE RALPH KUNTZ MD

Internal Medicine

1500 PLEASANT VALLEY WAY
SUITE 201
WEST ORANGE, NJ
ZIP 07052

(973) 324-1200

DR. JOHN KINTIROGLOU M.D.

Pediatrics

1500 PLEASANT VALLEY WAY
STE 306
WEST ORANGE, NJ
ZIP 07052

(973) 243-0002

DR. CONSTANTINOS KINTIROGLOU M.D.

Pediatrics

(Adolescent Medicine)

1500 PLEASANT VALLEY WAY
STE 306
WEST ORANGE, NJ
ZIP 07052

(973) 243-0002

RONALD G. FRANK MD,PC

Specialist

1500 PLEASANT VALLEY WAY
SUITE 201
WEST ORANGE, NJ
ZIP 07052

(973) 731-6600

MRS. LAUREN ILLYA KOHLBERG C.P.N.P

Nurse Practitioner

(Pediatrics)

1500 PLEASANT VALLEY WAY
SUITE 301
WEST ORANGE, NJ
ZIP 07052

(973) 243-0002

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1689969396, enumerated as an "organization" on June 10, 2011.

The provider is located at 1500 PLEASANT VALLEY WAY SUITE 301 WEST ORANGE, NJ 07052 and the phone number is (973) 243-0002.

Pediatrics with taxonomy code 2080A0000X and a focus in Adolescent Medicine.