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Organization
EVERGREEN MEDICAL GROUP PC
Active
Organization
EVERGREEN MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRIGORY SHTENDER MD (OWNER)
(201) 791-7771
Entity
Organization
Contact information
Practice address
887 KINDERKAMACK RD STE 2, RIVER EDGE, NJ 07661-2307
(201) 464-0860
(888) 440-2752
Mailing address
887 KINDERKAMACK RD STE 2, RIVER EDGE, NJ 07661-2307
(201) 464-0860
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
NULL
111N00000X
Chiropractor
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
NULL
2086S0129X
Vascular Surgery Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
363LA2200X
Adult Health Nurse Practitioner
—
NULL
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
NULL
363LG0600X
Gerontology Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
10/12/2023
Last updated
02/11/2025
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