State of New Jersey Medicaid Fraud Division Provider ...

State of New Jersey Medicaid Fraud Division

Provider Exclusion Report**ADDITIONAL NPI NUMBERS MAY BE ASSOCIATED WITH THE LISTED INDIVIDUALS/ENTITIES**

1

Updated on: 2/3/2022

For verifications please contact: [email protected] Send an email to [email protected] to receive this report in .xls format

PROVIDER NAME TITLE DATE OF BIRTH

NPI NUMBER STREET CITY STATE

ZIP ACTION EFFECTIVE DATE

EXPIRATION DATE

2258 PHARMACY, INC. 2258 THIRD AVENUE NEW YORK NY 10035 SUSPENSION 7/20/20036522 VENTNOR AVE. PHARMACY, INC.

6522 VENTNOR AVENUE VENTNOR NJ 08406 DISQUALIFICATION

ABARCA, CHERYL R. LPN 8/15/1962 528 3RD STREET NEWARK NJ 07107 SUSPENSION 6/20/2005ABASHKIN, ROMAN CHHA 12/21/1981 72 RIDGEVIEW TERRACE WAYNE NJ 07470 DISQUALIFICATION 5/29/2015ABASHKIN, ROMAN CHHA 12/21/1981 72 RIDGEVIEW TERRACE WAYNE NJ 07470 DISQUALIFICATION 6/3/2016ABBASSI, JADAN MD 9/19/1944 1194807255 1618 MAIN AVENUE CLIFTON NJ 07011 DISQUALIFICATION 11/21/2016 PERMANENTABBASSI, JADAN MD 9/19/1944 1194807255 115 NELLIS DRIVE WAYNE NJ 07470 DISQUALIFICATION 6/20/2018 PERMANENTABDALLA, IZZELDIN 4/5/1967 1116 ANNE STREET ELIZABETH NJ 07201 DISQUALIFICATION 11/10/1999ABDELGANI, AMIR ALLENWOOD USP WHITE DEER PA 17887 DISQUALIFICATION 11/26/2001ABDELGANI, FADIL TERRE HAUTE USP TERRE HAUTE IN 47808 DISQUALIFICATION 11/26/2001ABDELHAMID, MANAL RPH 5/28/1969 7100 BOULEVARD EAST, 11G GUTTENBERG NJ 07093 DEBARMENT 3/15/2001

ABDOLLAHI, MITRA DMD 8/31/1966 1033329230 646 N. SARATOGA DRIVE MOORESTOWN NJ 08057 DISQUALIFICATION 11/5/2007 7/19/2019ABERBACH, STEVEN RPH 8/5/1944 23 STONEGATE DRIVE WATCHUNG NJ 07069 DEBARMENT 12/19/2003ABOOD, ABDOLMAID S. 1/20/1966 64 BEVAN STREET JERSEY CITY NJ 07306 SUSPENSION 5/7/1997ABOODS MEDICAL LIVERY 64 BEVAN STREET JERSEY CITY NJ 07306 DISQUALIFICATION 5/22/1994

ABOUELHODA, AHMED RPH 3/23/1974 33-17 60TH STREET, APT. 1 WOODSIDE NY 11377 SUSPENSION 9/20/2005ABRAHAMSEN, SVEND DPM 9/17/1944 101 CHESTNUT RIDGE ROAD SADDLE RIVER NJ 07458 DISQUALIFICATION 4/20/1994

ABRAMS, DE'NYSHIA CHHA 11/16/1993 410 3RD AVENUE, APT. 1A ASBURY PARK NJ 07712 DISQUALIFICATION 7/16/2018ABRAMS, IRVING RPH 12/23/1949 5 LORENE WAY MORGANVILLE NJ 07551 SUSPENSION 4/27/2000ABREU MARTINEZ, CHHA 12/14/1989 14 EAST RUSSELL STREET CLIFTON NJ 07011 DEBARMENT 10/31/2017ABUSEF, ELSAYED K. SUTEX

MED. TRANSPORT

814 74TH STREET NORTH BERGEN NJ 07047 DISQUALIFICATION 5/20/1999

AC HOME NURSING 1235230665 2921 YOUNGSTOWN ROAD WARREN OH 44484 DISQUALIFICATION 11/20/2015ACKLEY, GEORGE PSYCH 5/13/1944 1457535833 202 LENOX AVENUE CAPE MAY NJ 08204 DEBARMENT 7/21/2015ACOSTA, LEILANI CHHA 4/14/1977 458 STEVENSON PLACE, 1ST

FLPERTH AMBOY NJ 08861 DISQUALIFICATION 5/9/2019

ACOSTA, PEDRO E. 1/23/1945 5815 43RD AVENUE WOODSIDE NY 11377 SUSPENSION 4/13/2008



2






EXPIRATION DATE

ACOSTA, PEDRO E. 1/23/1945 5815 43RD AVENUE WOODSIDE NY 11377 DISQUALIFICATION 5/2/2008ACOSTA, PEDRO E. 1/23/1945 5815 43RD AVENUE, 1ST

FLOORWOODSIDE NY 11377 DISQUALIFICATION 9/16/2011

ACOSTA, WILLIAM R. MD 8/24/1949 47 OSBORNE STREET JOHNSTOWN PA 15905 DISQUALIFICATION 11/20/2015ACQUAH, ROSE AKA MANFORD, ROSE

CHHA 10/1/1984 5507 WARNER VIEW LANE WESTVILLE OH 43081 DEBARMENT 7/13/2018

ACQUAIRE, FLORENCE 7/4/1940 EMCF PO BOX 08809 CLINTON NJ 08809 SUSPENSION 4/20/2006ACQUAYE, EDWARD 2/9/1950 10 BERWICK CIRCLE NORTH BRUNSWICK NJ 08902 SUSPENSION 4/19/2007ACZON, FERDINAND B. MD 11/29/1948 1255422135 204 SUMMIT ROAD MOUNT LAUREL NJ 08054 DISQUALIFICATION 9/20/2011 11/23/2016ADADEVOH, LOVESDALE AKA HAMENOO, LOVESDALE

CHHA 12/10/1977 1 SKYTOP GARDENS, APT. 19 PARLIN NJ 08859 DISQUALIFICATION 7/16/2019

ADAIR, LISA AKA TARASEVICH, LISA

LPN 4/20/1961 206 LAKEHURST AVENUE, APT. B

NATIONAL PARK NJ 08063 SUSPENSION 9/19/2002

ADAMS, AMELIA CHHA 9/26/1994 132 OAKMONT ROAD CLEMENTON NJ 08021 DISQUALIFICATION 1/31/2017ADAMS, ANTOINETTE CHHA 12/29/1976 1604 SEWALL AVENUE ASBURY PARK NJ 07712 DISQUALIFICATION 1/31/2017ADAMS, JAIME L. CHHA 4/15/1976 911 W. HAND AVENUE CAPE MAY COURT

HOUSENJ 08210 SUSPENSION 6/19/2003

ADAMSHICK, WILLIAM RPH 10/9/1960 1871842575 2516 HURRY ROAD FORKED RIVER NJ 08731 SUSPENSION 7/14/2005 3/21/2012ADDIS, DAVID J. MD 8/10/1944 1770656068 334 FARNSWORTH AVENUE BORDENTOWN NJ 08505 DEBARMENT 1/20/2015 PERMANENTADES, ALBERT MD 1/11/1955 1912069394 3 MARKHAM CIRCLE ENGLEWOOD NJ 07631 DEBARMENT 5/16/2016ADES, ALBERT MD 1/11/1955 1912069394 PO BOX 779800 MIAMI FL 33177 DISQUALIFICATION 12/12/2016ADES, ALBERT (DR.'S OFFICE)

1447560867 129 MADISON AVENUE CRESSKILL NJ 07626 DISQUALIFICATION 6/16/2017

ADISSON, LECLERC MD 8/14/1946 1482 SW 150TH TERRACE SUNRISE FL 33326 DISQUALIFICATION 7/20/2007 PERMANENTADISSON, LUNIC CHHA 11/29/1971 14 WALTER PLACE #1 IRVINGTON NJ 07111 DISQUALIFICATION 3/14/2008ADOLPHE, NAOMIE CHHA 8/24/1982 410 FISHER AVENUE NEPTUNE NJ 07753 DISQUALIFICATION 2/20/2017ADU-BOAHENE, KWABENA

CHHA 2/19/1975 3 AUGUSTA DRIVE LITTLE EGG HARBOR NJ 08087 DISQUALIFICATION 1/23/2018

AFRIYIE, BRIGHT CHHA 6/20/1994 317 W. RUNYON STREET, 3L NEWARK NJ 07108 DISQUALIFICATION 1/23/2018

AGARWAL, SHASHI K. MD 6/15/1952 1558416099 198 CENTRAL AVENUE, 1ST FL

EAST ORANGE NJ 07018 SUSPENSION 10/22/2012



3






EXPIRATION DATE

AGARWAL, SHASHI K. MD 6/15/1952 1558416099 FCI SCHUYLKILL, PO BOX 759 MINERSVILLE PA 17954 DEBARMENT 2/28/2014

AGRAWAL, PANKAJ MD 9/16/1949 1962661215 3 E. MEADOWBROOK CIRCLE SICKLERVILLE NJ 08081 DISQUALIFICATION 3/11/2006

AGRESTA JR., RUDOLPH G. MD 8/18/1954 PO BOX 7450 TRENTON NJ 08628 SUSPENSION 2/19/2004AGRESTI, JAMES MD 2/18/1970 1255389813/1

477874352292 FAIRMONT ROAD LONG VALLEY NJ 07853 DEBARMENT 10/5/2020

AGRESTI, ROBERT MD 4/11/1957 1619155710 15 BARBERRY WAY ESSEX FALLS NJ 07021 DISQUALIFICATION 6/26/2018AGUH, CHIKEZIE MD 6/23/1956 1407876261/1

61999748318 MULBERRY COURT BELLE MEAD NJ 08502 DISQUALIFICATION 2/11/2021

AGUIAR, SANDRA 2/3/1967 605 KNICKERBOCKER ROAD TENAFLY NJ 07670 DISQUALIFICATION 6/18/2009

AGUILAR, RUBEN RPH 9/21/1962 16 GOLDENROD DRIVE BELLE MEAD NJ 08502 SUSPENSION 7/20/2010AGUIRRE-MEDRANO, CANDIDA

10/24/1915 40 FERRY STREET NEWARK NJ 07105 DEBARMENT 7/12/1999

AGYEMANG, JOHN RPH 2/18/1969 1487934626 153 BLUE MEADOW LANE SICKLERVILLE NJ 08081 DISQUALIFICATION 12/28/2016 9/22/2020AGYEMANG, KWADWO RPH 3/8/1958 1154713394 94 MARKET STREET NEWARK NJ 07102 DEBARMENT 8/25/2003 6/3/2015AHLAWAT, RANVIR MD 7/21/1964 1447204615 2204 ARVELL STREET TOMS RIVER NJ 08755 DEBARMENT 12/19/2016 9/14/2021AHMAD, ABADULLAH 4/3/1984 280 LOUIS MARIN

BOULEVARD #15JERSEY CITY NJ 07302 SUSPENSION 2/19/2009

AHMAD, FAROOQ RPH 10/1/1943 1659605590 300 EAST HALSEY ROAD PARSIPPANY NJ 07054 SUSPENSION 11/8/1994AHMAD, NAEEM S 682 BERGEN AVENUE JERSEY CITY NJ 07306 DISQUALIFICATION 9/15/1983AHMAD, NAVEED MD 1/3/1950 1669412946 48 SUYDAM ROAD SOMERSET NJ 08873 DISQUALIFICATION 9/29/2016 PERMANENTAHMAD, NAVEED MD 1/3/1950 1669412946 48 SUYDAM ROAD SOMERSET NJ 08873 DISQUALIFICATION 12/20/2016 PERMANENTAHMED, AMIR E. 1/1/1962 7-11 TONNELLE AVENUE-

2MNJERSEY CITY NJ 07306 SUSPENSION 5/30/1997

AHMED, KHALID H. 2/6/1963 PO BOX 930 NEW YORK NY 10013 DISQUALIFICATION 3/26/1994AHMED, MOHAMED G. PHARM

TECH7/14/1989 5 WESTOVER TERRACE WEST ORANGE NJ 07052 DISQUALIFICATION 8/20/2010

AIRD, EILEEN, B. 6/28/1950 295 GRANDVIEW CIRCLE RIDGEWOOD NJ 07450 SUSPENSION 4/20/2003AKANDE, EZEKIEL MD 1/15/1959 1003859885 300 HAIL KNOB ROAD,

#290828SOMERSET KY 42503 DISQUALIFICATION 9/20/2017



4






EXPIRATION DATE

AKHMEDOV, KHUSEN 8/1/1990 SCI GRATERFORD, ME9849, PO BOX 244

GRATERFORD PA 19426 DISQUALIFICATION 11/20/2015

AKHTAR, NADEEM RPH 12/16/1959 1063695963 15 GRIST MILL LANE UPPER SADDLE RIVER NJ 07458 DEBARMENT 1/20/2012

AKHTAR, NADEEM RPH 12/16/1959 1063695963 15 GRIST MILL LANE UPPER SADDLE RIVER NJ 07458 DISQUALIFICATION 9/20/2012

AKINBILE, MORUFU O. RN 5/1/1966 419 E. MOOREHAVEN DRIVE CARSON CA 90746 DISQUALIFICATION 8/20/2010

AL SALIHI, FAROUK MD 7/1/1934 1720158025 1810 JOHN F. KENNEDY BOULEVARD

JERSEY CITY NJ 07305 SUSPENSION 5/1/2011

AL SALIHI, FAROUK MD 7/1/1934 1720158025 1810 JOHN F. KENNEDY BOULEVARD

JERSEY CITY NJ 07305 DEBARMENT 1/9/2015

ALAMEEN, ALWALEED TEMPT TRANS

5/16/1968 238 MAIN STREET HACKENSACK NJ 07601 SUSPENSION 7/18/1995

ALAN, DAVID OD 7/26/1946 1225012073 203 NORTH REDWOOD STREET

MASONTOWN PA 15461 DISQUALIFICATION 11/20/2015

ALBERS, HENRY J. EMT 8/22/1944 3 QUEEN STREET PARSIPPANY NJ 07054 DISQUALIFICATION 1/9/1996ALBINO, ETHAN RN 3/4/1989 224 FERN AVENUE HADDON TOWNSHIP NJ 08108 DISQUALIFICATION 9/7/2017ALCAIDE, KELLEY LPN 2/4/1969 716 RIVER ROAD SOMERVILLE NJ 08844 SUSPENSION 2/20/2002ALEXANDER, EDWARD J. MD 6/4/1955 8001 CASTOR AVENUE, SUITE

326PHILADELPHIA PA 19152 DEBARMENT 8/8/2000

ALEXANDER, JULIE B. RPH 8/20/1972 1525 DOGWOOD DRIVE CHERRY HILL NJ 08003 SUSPENSION 5/19/2005ALEXANDRA, ALYCIA AKA DOTRO, ALYCIA

RN 5/9/1975 6 LOWELL ROAD MANALAPAN NJ 07726 DISQUALIFICATION 11/23/2019

ALFONSO, NORMA CHHA 5/21/1948 144 SUMMIT STREET ENGLEWOOD NJ 07631 SUSPENSION 8/19/1997AL-GHRAOUI, FADI MD 4/9/1955 PO BOX 23429 FORT LAUDERDALE FL 33307 DISQUALIFICATION 11/18/2004 DECEASEDALI, HANIFAH CHHA 12/3/1990 1216 FALCON DRIVE ABSECON NJ 08201 DISQUALIFICATION 2/20/2017ALI, MOHAMED T. 4/18/1954 64 BEVAN STREET JERSEY CITY NJ 07306 DISQUALIFICATION 5/31/1994ALI, RAUSHANAH LPN 12/26/1980 103 BONNIA AVENUE TRENTON NJ 08629 DISQUALIFICATION 8/3/2019ALI, SAQIB 3/14/1954 MDC BROOKLYN, PO BOX

3290BROOKLYN NY 11232 DEBARMENT 5/20/2012

ALI, TARIK TARK TRANS

566 BLOOMFIELD AVENUE BLOOMFIELD NJ 07306 DISQUALIFICATION 5/10/1999



5






EXPIRATION DATE

ALLEN, ADINA CHHA 8/21/1979 219 PINEBROOK DRIVE MANTUA NJ 08051 DISQUALIFICATION 5/22/2017ALLEN, DEBRA CHHA 7/9/1961 18 REID LANE MILLSTONE

TOWNSHIPNJ 08535 DISQUALIFICATION 9/6/2019 PERMANENT

ALLEN, KENNYATTA G. 1/14/1976 148 CORNERSTONE PLACE WHITEHALL PA 18052 DISQUALIFICATION 3/14/2008ALLEN-BROGAN, MELANIE A.

8/1/1984 135 WILD OAKS COURT LITTLE EGG HARBOR NJ 08701 SUSPENSION 3/5/2008

ALLIED CLINICAL LAB, INC. 5199 S. GREEN STREET SALT LAKE CITY UT 84123 DISQUALIFICATION 6/18/1997ALLIED CLINICAL LAB, INC. 863 MCCALLIE AVENUE CHATTANOOGA TN DISQUALIFICATION 6/18/1997ALLRED, ELLEN ANNE RN 3/11/1975 571 FERNWOOD LANE FAIRLESS HILLS PA 19030 DISQUALIFICATION 11/20/2015ALLSTATE AMBULANCE CORPORATION

PO BOX 1011 UNION NJ 07083 DISQUALIFICATION 4/3/2000

ALPERIN, MARTIN MD 8/20/1927 28 RIVERSIDE AVENUE RED BANK NJ 07701 DEBARMENT 6/19/2000ALPERT, PERRY DDS 8/4/1941 1952668782 560 NEWARK AVENUE ELIZABETH NJ 07208 SUSPENSION 10/2/1995 8/26/2020ALSTON, SHERRELLE 12/11/1970 NORTH 52ND STREET PHILADELPHIA PA 19139 DEBARMENT 10/9/2007ALTOONIAN, ANN MARIE RN 6/29/1966 82 CONTANT AVENUE, APT. 2 LODI NJ 07644 DISQUALIFICATION 5/11/2019

ALVIS, SANDRA CHHA 5/29/1955 1421 HOLLINSHED AVENUE PENNSAUKEN NJ 08110 SUSPENSION 5/19/2005ALY, ABUBAKR CRESCEN

T TRANS5/26/1955 24 BRANFORD PLACE NEWARK NJ 07102 DISQUALIFICATION 3/11/2004

ALY, AHMED F. RPH 4/16/1974 1030 LIBERTY AVENUE UNION NJ 07083 SUSPENSION 8/17/2007ALY, WAEL 10/30/1966 1137 MAIN AVENUE CLIFTON NJ 07011 SUSPENSION 5/30/2000AMABILE, JOHN C. OD 4/23/1962 HIGHWAY #35 & 3RD

AVENUEOCEAN NJ 07712 DISQUALIFICATION 6/30/2002

AMAKER, PHYLLIS CHHA 3/25/1960 475 LIVINGSTON DRIVE EAST WINDSOR NJ 08520 DISQUALIFICATION 1/31/2017AMANKWAH, VINCENTIA 11/4/1978 8 MAPLES AVENUE CLIFFWOOD NJ 07721 DEBARMENT 5/1/2016

AMANKWAH, VINCENTIA 11/4/1978 8 MAPLES AVENUE CLIFFWOOD NJ 07721 DISQUALIFICATION 3/28/2017

AMATO, CARLO DC 7/3/1961 1275673360 500 RIVER AVENUE LAKEWOOD NJ 08701 DISQUALIFICATION 9/18/2018AMATO, NICOLA DC 3/1/1963 1366941627 3 MULLIGAN DRIVE FLANDERS NJ 07836 SUSPENSION 6/20/2005AMATO, STEVEN P. DC 8/1/1955 30151 FISH ROCK ROAD YORKVILLE CA 95494 DISQUALIFICATION 10/20/2009



6






EXPIRATION DATE

AMATO, VANESSA A. AKA NOWINSKI, VANESSA

RN 3/21/1977 65 LOCUST AVENUE NORTH ARLINGTON NJ 07031 SUSPENSION 9/19/2003

AMBROSE, DEAN A. DO 6/18/1957 1598832560 119 NORTH CENTRE STREET MERCHANTVILLE NJ 08109 DEBARMENT 2/1/2002

AMENYITOR, APEAFA CHHA 3/9/1987 14 MARSHALL STREET, APT. 14W

IRVINGTON NJ 07111 DISQUALIFICATION 2/20/2017

AMERICAN EXPRESS LOAN, INC.

1386883239 13420 DAMAR DRIVE, SUITE C

PHILADELPHIA PA 19116 DISQUALIFICATION 11/20/2015

AMERICAN MED. TECH., INC.

1072 MADISON AVENUE LAKEWOOD NJ SUSPENSION 4/14/1999

AMERICAN MEDICAL EXPRESS AMBULANCE, LLC.

1205071883 PO BOX 3093 WARMINSTER PA 18974 DISQUALIFICATION 11/20/2015

AMES, TRISHEENA CHHA 5/5/1991 96 HALSEY REED ROAD CRANBURY NJ 08512 DISQUALIFICATION 6/28/2018AMIN, PRISCILLA CHHA 6/18/1990 133 ATLANTIC STREET HACKENSACK NJ 07601 DEBARMENT 10/23/2017AMON, TAMERLANE CNA 8/8/1979 394 EGE AVENUE JERSEY CITY NJ 07304 DISQUALIFICATION 7/16/2018AMON, TAMERLANE CNA 8/8/1979 394 EGE AVENUE JERSEY CITY NJ 07304 DISQUALIFICATION 5/18/2019AMPARO, VIANNE AKA PAYANO, VIANNE

CHHA 10/2/1982 710 EAST 18TH STREET PATERSON NJ 07501 DISQUALIFICATION 1/31/2017

AMPOFO, TWUMASI 6/3/1968 12 MARSHALL STREET #7W IRVINGTON NJ 07111 SUSPENSION 2/1/2008AMPOFO, TWUMASI 6/3/1968 12 MARSHALL STREET #7W IRVINGTON NJ 07111 DISQUALIFICATION 3/30/2009ANAND, NEIL MD 3/15/1977 1982626818 26 TAFT LANE MORRISTOWN NJ 07960 DISQUALIFICATION 12/18/2019ANAND, SUBINA DMD 8/30/1967 1982781589 17 GROVERS MILL ROAD PLAINSBORO NJ 08536 DISQUALIFICATION 12/20/2012ANAND, SUBINA DMD 8/30/1967 1982781589 17 GROVERS MILL ROAD PLAINSBORO NJ 08536 DISQUALIFICATION 4/17/2012ANDAS PHARMACEUTICAL SUPPLY CORP.

592 PALISADE AVENUE TEANECK NJ 07666 DISQUALIFICATION 5/20/2018

ANDERSON, CHARMAINE RN 10/16/1973 95 FARRAGUT ROAD NORTH PLAINFIELD NJ 07062 DISQUALIFICATION 6/28/2017

ANDERSON, DAVID RN 4/3/1951 519 HOBART AVENUE TRENTON NJ 08629 SUSPENSION 10/20/2003ANDERSON, FRANCINE CHHA 7/6/1967 901 PRINCETON AVENUE LAKEWOOD NJ 08701 DISQUALIFICATION 2/12/2018ANDERSON, JOHN P. MD 8/25/1926 362 S. LAUREL STREET WAYNEBORO VA 22980 SUSPENSION 1/20/1999



7






EXPIRATION DATE

ANDERSON, NICOLE RN 8/27/1986 1801 HUNTINTON MEWS CLEMONTON NJ 08021 DISQUALIFICATION 8/28/2017ANDRADE, GLORIA LCSW/LC

ADC9/18/1962 1992804850 679 GRANT TERRACE TEANECK NJ 07666 SUSPENSION 6/18/2018

ANDREWS, TANELLE RN 8/16/1979 1340 S. ORCHARD ROAD VINELAND NJ 08360 DISQUALIFICATION 5/25/2019ANDUJAR, EDWARD MD 12/23/1955 516 E. WOOD STREET VINELAND NJ 07410 DISQUALIFICATION 1/20/2006ANELLO, ALLYSON PHARM

TECH9/30/1984 708 FOX HILL DRIVE DOVER NJ 07801 DISQUALIFICATION 2/5/2018 PERMANENT

ANEROUSIS, MARY DEE DDS 11/26/1965 1871675769 383 SOUTH ORANGE AVENUE LIVINGSTON NJ 07039 DISQUALIFICATION 5/20/2019

ANGEL, CHRISTINA CHHA 5/9/1989 145 PRESIDENTIAL BOULEVARD, APT. 16J

PATERSON NJ 07522 DISQUALIFICATION 2/20/2017

ANGELES, KATHERINE MD 4/6/1958 191 ROUTE 37 WEST TOMS RIVER NJ 08755 DEBARMENT 6/23/1995 DECEASEDANGELO, JOSEPH 3/9/1949 34 STONEHEDGE ROAD LINCROFT NJ 07738 DISQUALIFICATION 4/27/1993ANODIDE, PAUL A. DDS 2/4/1956 1841317625 23 BLUE DEVIL LANE TRENTON NJ 08619 DISQUALIFICATION 2/3/2006ANSERE, PATIENCE CHHA 305 COOLIDGE AVENUE ENGLEWOOD NJ 07631 DISQUALIFICATION 7/17/2018ANTELL, CLIFF 12/26/1974 FCI CUMBERLAND, PO BOX

1000CUMBERLAND MD 21501 DISQUALIFICATION 5/18/2019

ANTHONY, QUINT LPN 4/7/1956 900 BARNEGAT BOULEVARD N #908

BARNEGAT NJ 08005 DISQUALIFICATION 6/5/2017

ANTONE, JULIE LCSW 8/9/1980 366 CAMBRIDGE DRIVE RAMSEY NJ 07446 DEBARMENT 2/20/2013ANTWI, ISAAC CHHA 6/28/1983 549 BOLTON AVENUE #1 BRONX NY 10473 DEBARMENT 6/28/2018ANZALONE, ANTHONY MD 9/23/1952 1124071857 203 DIETZ STREET CRANFORD NJ 07016 DISQUALIFICATION 2/8/2019 PERMANENTAPONTE, DENNIS MD 9/23/1966 1053458018 MDC BROOKLYN, PO BOX

329002BROOKLYN NY 11232 DISQUALIFICATION 5/20/2015

AQUILANTE, JOHN C. RPH 8/13/1946 27 ROCKLEDGE PLACE CEDAR GROVE NJ 07009 DISQUALIFICATION 9/23/1983 DECEASEDARDAN, MARGO RN 8/5/1963 161 CONAWAGA TRAIL MEDFORD NJ 08055 DISQUALIFICATION 6/28/2017ARDEHALI, MOHAMMAD MD 12/19/1944 193 ELWOOD AVENUE NEWARK NJ 07104 SUSPENSION 2/20/2001

ARGUETA, ALVARO MD 4/13/1942 1194851618 9408 BIG VIEW DRIVE AUSTIN TX 78730 DISQUALIFICATION 7/22/2017 PERMANENTARGUETA, EDWARD A. CNA 4/13/1972 604 N. BAYVIEW AVENUE SEASIDE PARK NJ 08752 SUSPENSION 4/8/1999ARGUETA, EDWARD A. CNA 4/13/1972 604 N. BAYVIEW AVENUE SEASIDE PARK NJ 08752 SUSPENSION 9/13/1999ARIF, MOHAMMED 4/5/1965 147-14 14TH AVENUE WHITESTONE NY 11375 DISQUALIFICATION 12/1/1998ARMBRISTER, KATIMA CHHA 4/12/1973 301 BELMAR AVENUE NEPTUNE NJ 07753 DISQUALIFICATION 2/20/2017



8






EXPIRATION DATE

ARNESON, VICTORIA RN 4/1/1969 42 HOLLY STREET CRANFORD NJ 07016 SUSPENSION 9/19/2003AROWOSAYE, EMILY RN 5/12/1967 24 CUNNINGHAM DRIVE WEST ORANGE NJ 07052 DISQUALIFICATION 7/31/2010AROWOSAYE, EMILY RN 5/12/1967 24 CUNNINGHAM DRIVE WEST ORANGE NJ 07052 DEBARMENT 5/20/2012AROWOSAYE, ISAAC 10/8/1956 24 CUNNINGHAM DRIVE WEST ORANGE NJ 07052 DEBARMENT 3/30/2010AROWOSAYE, ISAAC 10/8/1956 24 CUNNINGHAM DRIVE WEST ORANGE NJ 07052 DEBARMENT 7/4/2014ASHOKAN, ANNAMALAI MD 7/6/1953 1497857270 7 ROCKLEDGE DRIVE SUFFERN NY 10901 DEBARMENT 5/1/2004ASKANAZI, JEFFREY MD 3/23/1951 2322 OLDE FARM LANE HUDSON OH 44236 DEBARMENT 7/19/1999ASLAM, ZAHID MD 9/3/1972 1306906854 1814 E. 2ND STREET SCOTCH PLAINS NJ 07076 DISQUALIFICATION 1/16/2019 PERMANENTASTON, ALEXIA L. LPN 2/12/1980 15 PRIMROSE LANE, APT. 3 DELRAN NJ 08075 DISQUALIFICATION 6/18/2009ASTORE, MARYANN CHHA 9/3/1961 45 KOHOMO AVENUE ERIAL NJ 08081 DEBARMENT 4/30/2019ATIENZA, CESAR P. MD 12/12/1943 1164491494 56 COLD INDIAN SPRING

ROADOCEAN NJ 07712 DISQUALIFICATION 8/6/1991

ATKINS, DAWN AKA STILL, DAWN

CHHA 9/17/1988 697 EVERETT STREET CAMDEN NJ 08104 DISQUALIFICATION 3/6/2018

AUFSEESER, LESLIE DPM 10/21/1948 1164410742 11 MEADOWS LANE WAYSIDE NJ 07712 DEBARMENT 2/12/2018AUSTIN, BRITTANY CHHA 11/11/1992 420 N. SOUTH CAROLINA

AVENUEATLANTIC CITY NJ 08401 DISQUALIFICATION 6/6/2018

AUSTIN, DONALD P 3/3/1960 31 MADISON AVENUE MONTCLAIR NJ 07042 DISQUALIFICATION 6/1/1993AUSTIN, NIDERIA CHHA 8/5/1994 822 GALINDEZ COURT CAMDEN NJ 08102 DISQUALIFICATION 12/15/2017AVILES, REBECCA CHHA 2/6/1988 67 MILL ROAD LEVITTOWN PA 19057 DISQUALIFICATION 2/20/2017AVON PHARMACY 300 MAIN STREET AVON NJ 07717 SUSPENSION 2/5/2003AYALA, ANDRES 7/20/1954 33 MADISON AVENUE CHERRY HILL NJ 08002 SUSPENSION 9/11/2017 10/3/2019AYALA, ANDRES 7/20/1954 33 MADISON AVENUE CHERRY HILL NJ 08002 DISQUALIFICATION 10/3/2019AZAM, CHOWDHURY F. MD 7/1/1954 1922053792 38 ORIOLE DRIVE HACKETTSTOWN NJ 07840 DEBARMENT 2/1/1999 6/30/2015AZAM, CHOWDHURY F. MD 7/1/1954 1922053792 30 DUNSTON LANE MONMOUTH

JUNCTIONNJ 08852 DEBARMENT 10/26/2016

AZIZ-DURRANI, 8/14/1948 328 SIP AVENUE JERSEY CITY NJ 07306 SUSPENSION 9/19/2002AZU, PHILIP N. RPH 3/10/1957 2836 DEBRA WAY UNION NJ 07083 DISQUALIFICATION 5/20/1999AZU, PHILIP N. RPH 3/10/1957 1094 CLINTON AVENUE IRVINGTON NJ 07111 DISQUALIFICATION 4/19/2001BABARIA, ASHOKKUMAR R.

MD 2/23/1950 1538100599 FCI FORT DIX, PO BOX 2000 FORT DIX NJ 08640 DISQUALIFICATION 11/4/2014

BABARIA, ASHOKKUMAR R.

MD 2/23/1950 1538100599 208 QUAKERBRIDGE COURT MOORESTOWN NJ 08057 SUSPENSION 1/10/2012



9






EXPIRATION DATE

BABARIA, ASHOKKUMAR R.

MD 2/23/1950 1538100599 5756 HARTFIELD/POINTVILLE FORT DIX NJ 08640 DISQUALIFICATION 2/28/2015

BABAYANTS, ALEXANDER MD 8/23/1955 1194779371 184 S. LIVINGSTON AVENUE #9272

LIVINGSTON NJ 07039 DEBARMENT 2/10/2018 10/21/2021

BACSENKO, JENNIFER PHARM TECH

3/18/1976 103 STATE STREET LINWOOD NJ 08221 SUSPENSION 1/20/2011

BADAWY, BADAWY MD 12/27/1962 1679615553 2738 JOHN F. KENNEDY BOULEVARD 1ST FL

JERSEY CITY NJ 07306 DISQUALIFICATION 2/11/2016

BADAWY, BADAWY MD 12/27/1962 1679615553 2738 JOH F. KENNEDY BOULEVARD 1ST FL

JERSEY CITY NJ 07306 SUSPENSION 3/25/2013

BADO, JEFFREY DO 8/27/1955 1801908173 1615 ASHBOURNE ROAD ELKINS PARK PA 19027 DISQUALIFICATION 11/20/2015BADO, JEFFREY #71927-066

DO 8/27/1955 1801908173 FDC PHILADELPHIA, PO BOX 562

PHILADELPHIA PA 19105 DISQUALIFICATION 11/20/2017

BADUINI, JOLIE RN 6/26/1989 1300 32ND AVENUE SW, APT. 307

MINOT ND 58701 DISQUALIFICATION 5/20/2015

BAER, MICHAEL L. DC 6/12/1953 1053654616 BAYSIDE STATE PRISON, PO BOX F-1

LEESBURG NJ 08327 SUSPENSION 9/20/2004

BAEZ, ANNA DDS 3/6/1961 911 VILLAGE DRIVE SOMERSET NJ 08873 SUSPENSION 3/20/2002BAFFOWAAH, ZIBORAH 12/15/1970 4345 DIAMOND DRIVE SAINT PAUL MN 55122 DISQUALIFICATION 2/20/2015BAGDASAROVA, ANGELICA

RN 7/17/1964 11981 AUDUBON AVENUE PHILADELPHIA PA 19116 DISQUALIFICATION 11/20/2015

BAH, HUSAINATU RN/LPN 9/9/1988 2510 BIRCHWOOD COURT NORTH BRUNSWICK NJ 08902 DISQUALIFICATION 1/15/2016 12/10/2019BAH, HUSAINATU RN/LPN 9/9/1988 2510 BIRCHWOOD COURT NORTH BRUNSWICK NJ 08902 DISQUALIFICATION 11/28/2013 12/10/2019BAHNSON, WILLIAM F. MD 11/12/1927 28 HIGH STREET TREENFIELD MA 01301 DISQUALIFICATION 9/2/1988 DECEASEDBAILEY, FREDERICK DDS 1/29/1960 1205048410 41 WEST GLEN ROAD DENVILLE NJ 07834 DISQUALIFICATION 9/29/2016BAIRD, DAVID B. MD 5/11/1937 4107 MERCHANT SQUARE

PLACELANSDALE PA 19446 SUSPENSION 5/20/2004

BAJAKIAN, BRYAN DC 6/22/1959 1679618094 3105 STOWE LANE MAHWAH NJ 07430 DISQUALIFICATION 10/18/2010BAJWA, LATIF AHMAD ACCUPU

NCTURIST

5/7/1948 PO BOX 633 LANGHORNE PA 19047 SUSPENSION 2/9/2009

BAKER, MONIQUE CHHA 12/24/1993 1521 NEWPORT STREET CAMDEN NJ 08104 DISQUALIFICATION 2/28/2019



10






EXPIRATION DATE

BAKER, SCOTT CNA 3/31/1972 215 BURLINGTON ROAD SOUTH

BRIDGETON NJ 08302 DISQUALIFICATION 5/24/2002

BAKMAN, MILANA CHHA 9/28/1969 4 IVY WAY DAYTON NJ 08810 DEBARMENT 6/19/2018BALLERAS, ALFREDO B. RPH 1/21/1972 1 VISTA DRIVE MOUNT OLIVE NJ 07836 DISQUALIFICATION 9/14/2010 9/13/2013BAMDAD, BABAK RPH 8/21/1968 1285950642 2 SOUTH GATE ROAD, APT.

736GREAT NECK NY 11023 DISQUALIFICATION 7/26/2011

BAMDAD, BABAK RPH 8/21/1968 1285950642 333 RIVER STREET HOBOKEN NJ 07030 DEBARMENT 6/1/2010BAMGBOYE, PATRICK DDS 1/1/1948 1720175508 358 MEISEL AVENUE SPRINGFIELD NJ 07081 DEBARMENT 11/7/2012BANDY, ANHUAR 5/28/1963 141 CRINE ROAD COLTS NECK NJ 07722 DISQUALIFICATION 6/20/2018BANDY, KARIM 2/27/1962 141 CRINE ROAD COLTS NECK NJ 07722 DISQUALIFICATION 6/20/2018BANGOURA, ALPHA 1/1/1974 200 EXECUTIVE DRIVE WEST ORANGE NJ 07050 SUSPENSION 3/22/2006BANKA, VIDYA MD 3/5/1941 1588659965 237 STACEY ROAD PENN VALLEY PA 19072 DISQUALIFICATION 3/19/2018BANKS, KENNETH 5/13/1934 640 PINE STREET CAMDEN NJ 08103 DEBARMENT 8/14/2003BAPTISTE, STANLEY CHHA 1/17/1992 401 WEST VIRGINIA AVENUE,

APT B-16NEPTINE NJ 07753 DISQUALIFICATION 4/19/2018

BARAHONA, RONY 8/9/1962 549 SUMMIT AVENUE MAPLEWOOD NJ 07040 DEBARMENT 3/26/2013 BARAN-DICRISCIO, LORRAINE

CHHA 12/3/1939 309 IRIS ROAD CHERRY HILL NJ 08620 SUSPENSION 3/20/2002

BARAQUE, IVAN DARIO MD 1/31/1950 1811059967 4 WOODCREST COURT WEST NYACK NY 10994 DISQUALIFICATION 2/20/2015BARASCH, MILTON RPH 1/15/1935 12 IVY WAY ABERDEEN NJ 07747 DEBARMENT 8/3/2000 DECEASEDBARATTI, CARMEN DO 7/16/1934 150 KIRKBRIDGE ROAD VOORHEES NJ 08043 SUSPENSION 9/4/1997BARBA, FIDELIS MD 4/25/1948 2 POWDER HILL SADDLE RIVER NJ 07458 DISQUALIFICATION 10/11/2000BARBER-HINSON, CONNIE 1/4/1958 7011 SHADOW RUN SAN ANTONIO TX 78250 SUSPENSION 4/20/2011BARBERS-WEBER, JENNIFER

12/10/1969 8 ELKRIDGE PARKWAY MANALAPAN NJ 07726 SUSPENSION 11/5/2009

BARDEN, BRENDA RN 7/5/1955 19 INTERVALE ROAD SALEM MA 01970 DISQUALIFICATION 12/20/2012BARDO, MANUEL 6/19/1944 11756 SW 14TH TERRACE MIAMI FL SUSPENSION 8/19/2004BARET, MICHELLE CHHA 6/4/1989 135 MARINA DRIVE EDISON NJ 06076 DISQUALIFICATION 2/8/2017BARGE, NICHOLAS 6/7/1989 716 NAUTILUS STREET FORKED RIVER NJ 08731 DEBARMENT 3/16/2011 BARI, ABDUL 8/2/1954 264 PROSPECT STREET NUTLEY NJ 07110 DISQUALIFICATION 6/19/2009BARIEXCA, CARLA LPN 12/14/1974 107 DAYTON STREET TRENTON NJ 08610 SUSPENSION 8/20/2006BARNA, ARLENE RN 2/12/1936 205 KRAFT AVENUE OAKLYN NJ 08107 SUSPENSION 9/19/2003BARNWELL, LATANYA 1/23/1984 1048 PENNINGTON ROAD EWING NJ 08618 DEBARMENT 9/16/2011 9/17/2014



11






EXPIRATION DATE

BARON, MICHAEL B. MD 2/27/1947 SE 1256 BISHOP BOULEVARD, STE 1

PULMAN WA 99163 DEBARMENT 9/11/2000

BARONE, THOMAS DO 1/22/1969 1780898965 255 17TH STREET, SUITE 601 PHILADELPHIA PA 19103 DISQUALIFICATION 11/20/2015

BARROUS, FELIPE EMT 9/6/1988 40 KNOLL TERRACE HAZLET NJ 07730 DISQUALIFICATION 2/28/2015BARSH, LAUREN AKA MCCABE, LAUREN

RN 4/10/1982 9 FIELDCREST WAY HAZLET NJ 07730 DISQUALIFICATION 12/30/2019

BARTLOW, BRIAN 3/3/1960 551 PARKWOOD AVENUE TOMS RIVER NJ 08753 SUSPENSION 7/17/2003BAS, KONSTANTIN 10/4/1975 2800 COYLE STREET #625 BROOKLYN NY 11235 DISQUALIFICATION 9/14/2018BASBUS, VIICTOR M. MD 7/18/1944 1811098858 33 5TH AVENUE, APT. 1B NEW YORK NY 10003 DEBARMENT 2/6/2009BASCUS, NAOMI AKA DERRICK, NAOMI

RN 5/5/1975 6 ENGLISH IVY DRIVE SICKLERVILLE NJ 08081 DISQUALIFICATION 12/26/2016

BASCUS, NAOMI AKA DERRICK, NAOMI


BASSO, NICHOLAS V. MD 12/13/1945 7665 MAPLE AVENUE PENNSAUKEN NJ 08109 DEBARMENT 2/1/2000BATARSEH, BASEL MD 5/12/1960 1063602696/1

891803318620 FAIRLAWN AVENUE GLEN ROCK NJ 07410 DEBARMENT 12/31/2017

BATARSEH, BASEL MD 5/12/1960 1063602696/1891803318

85 VINCENT DRIVE CLIFTON NJ 07013 DISQUALIFICATION 8/20/2018

BATEMAN, PAMELA LPN 6/19/1956 91 CHESTNUT STREET SALEM NJ 08079 SUSPENSION 7/21/2008BATES, NANCY M. DO 9/10/1955 1043435209 38 PALSA AVENUE ELMWOOD PARK NJ 07407 DEBARMENT 4/3/2001BATTLE, TIFANY CHHA 5/13/1981 393 IRVINE TURNER

BOULEVARD, APT. 4DNEWARK NJ 07108 DISQUALIFICATION 2/20/2017

BAUBLITZ, CARRIE RN 6/2/1973 80 CONEWAGO DRIVE HANOVER PA 17331 DISQUALIFICATION 12/29/2015BAUTISTA, FILOMENA CHHA 7/31/1946 133 PAMRAPO AVENUE #1 JERSEY CITY NJ 07305 DISQUALIFICATION 7/14/2017BAXTER, LOUIS E. MD 3/17/1952 1962527051 2 MANCHESTER COURT COLUMBUS NJ 08022 DISQUALIFICATION 10/26/1983 4/2/2013BEACHUM-THOMPSON, AMY

CHHA 1/11/1992 201 WEBSTER STREET WOODBINE NJ 08270 DISQUALIFICATION 1/17/2018 8/20/2018

BEALS, PAUL V. MD 4/15/1943 1427175652 4120 WESTFIELD AVENUE PENNSAUKEN NJ 08110 SUSPENSION 6/24/2014BEASLEY, BRANDI CNA 12/13/1995 433 ALFRED ROAD TOMS RIVER NJ 08757 DISQUALIFICATION 2/11/2019 PERMANENTBEAUCEJOUR, MONIQUE CHHA/C

NA8/5/1973 204 BERKELEY AVENUE, APT.

313BLOOMFIELD NJ 07003 DISQUALIFICATION 8/29/2019

BECK, ALLAN G. MD 2/5/1944 1833 ARROWHEAD DRIVE WATERFORD NJ 08089 SUSPENSION 2/20/2001



12






EXPIRATION DATE

BECKETT, DONALD DPM 12/28/1948 1871692285 10144 DEERCLIFF DRIVE TAMPA FL 33647 DISQUALIFICATION 11/4/2005BECKFORD, AUDREY L. 6/1/1968 566 NORTH MAPLE AVENUE EAST ORANGE NJ 07017 SUSPENSION 1/20/2002

BEDRICK, BERNARD A. 300 EAST 5 6TH STREET NEW YORK NY 10022 DISQUALIFICATION 6/1/1993BEECHER, GEORGE MD 9/26/1940 1073574059 137 EVERGREEN AVENUE NW PROVIDENCE NJ 07974 DISQUALIFICATION 9/19/2018 PERMANENTBEECHER, GEORGE MD 9/26/1940 1073574059 137 EVERGREEN AVENUE NW PROVIDENCE NJ 07974 SUSPENSION 6/8/2016 9/19/2018BEHRMAN, EDWARD DO 10/9/1932 520 HAMBURG TURNPIKE WAYNE NJ 07470 DISQUALIFICATION 12/1/1998BEIRNE, MARY F. MD 6/25/1949 1881782662 75 ABE VORHEES AVENUE MANASQUAN NJ 08736 DISQUALIFICATION 7/19/2001 5/16/2011BEKIER, JACQUELYN CHHA 10/11/1993 518 LAKE TERRACE BRADLEY BEACH NJ 07720 DISQUALIFICATION 1/31/2017BELIAEV, KIRA CHHA 12/12/1957 108 36TH STREET UNION CITY NJ 07087 DISQUALIFICATION 2/20/2017BELKOFF, MEYER DO 9/9/1921 29 ELMORA AVENUE ELIZABETH NJ 07202 DEBARMENT 7/17/1998 DECEASEDBELL, BEANA 1/30/1982 9926 HALDEMAN AVENUE PHILADELPHIA PA 19115 DISQUALIFICATION 11/20/2015BELL, KIMBERLY F. RN 11/9/1961 2030 HIGHWAY 35 N. UNIT K ORTLEY BEACH NJ 08735 SUSPENSION 6/20/2001 2/7/2020

BELL, SHANNON PHARM TECH

2/23/1979 6591 MILL ROAD EGG HARBOR TOWNSHIP

NJ 08234 DISQUALIFICATION 5/23/2017

BELLAMY, BERNICE 5/24/1957 1 CRISPIN ROAD LUMBERTON NJ 08060 DEBARMENT 10/20/2004BELLAMY, HARVEY H&B

TRANS.9/30/1962 CRAF PO BOX 7450 TRENTON NJ 08625 DISQUALIFICATION 10/20/2004

BELLO, REY N. MD 11/18/1957 1780796409 444 60TH STREET WEST NEW YORK NJ 07093 SUSPENSION 1/31/2011 PERMANENTBELMAR HOMETOWN PHARMACY

911 MAIN STREET BELMAR NJ 07719 SUSPENSION 2/5/2003

BELONY, IVELYSE LPN 9/4/1989 131 PARK PLACE, APT. 1 IRVINGTON NJ 07111 DISQUALIFICATION 3/28/2017BELTZER, BLAIR MD 5/5/1957 1073635421 2025 HAMBURG TURNPIKE WAYNE NJ 07470 DEBARMENT 12/16/2015BENKO, ALICIA PHARM

TECH12/27/1986 FCI DANBURY RT 37, #60674-

050DANBURY CT 06811 DISQUALIFICATION 9/18/2009

BENNETT, SHARON CHHA 9/27/1954 736 EDGEWOOD AVENUE TRENTON NJ 08618 DISQUALIFICATION 1/31/2017BENNETT-WILLIAMSON, KATHLEEN

LPN 7/12/1951 75 WALT WHITMAN WAY TRENTON NJ 08690 DISQUALIFICATION 8/27/2001

BENSEMKY, AMINA CHHA 5/29/1967 2828 KENNEDY BOULEVARD, APT. 361

JERSEY CITY NJ 07306 DISQUALIFICATION 4/26/2019 PERMANENT

BENSIMHON, GEORGES MD 2/1/1947 1649234394 1488 SHELBURNE COURT ALLENTOWN PA 18104 DEBARMENT 12/16/2015BENTLEY, CYNTHIA RN 10/7/1959 220 GILPIN ROAD WILLOW GROVE PA 19090 DISQUALIFICATION 6/15/2018



13






EXPIRATION DATE

BENTON, DEBORAH AKA KING, DEBORAH

LPN 5/10/1958 9 RADFORD PLACE WILLINGBORO NJ 08046 DISQUALIFICATION 10/18/2001 11/5/2018

BERGER, SHELDON H. MD 5/26/1929 1032 ROUTE 34 MATAWAN NJ 07747 DEBARMENT 9/30/2000BERKELHAMMER, EDWARD

MD 12/18/1941 230 W. JERSEY STREET ELIZABETH NJ 07202 DISQUALIFICATION 8/30/1990

BERKS PSYCHIATRY 1104949149 146 SOUTH 5TH STREET READING PA 19602 DISQUALIFICATION 11/20/2015BERMAN, LARRY R. DDS 12/14/1953 1326191347 308 RARITAN AVENUE HIGHLAND PARK NJ 08904 DISQUALIFICATION 8/24/2010BERMAN, LARRY R. DDS 12/14/1953 1326191347 308 RARITAN AVENUE HIGHLAND PARK NJ 08904 DISQUALIFICATION 12/20/2012BERRY, BRADLEY D. MD 4/10/1919 PO BOX 2008 GRUNDY VA 24614 DISQUALIFICATION 6/13/1991 DECEASEDBEST, ALEXANDER C. 3/19/1969 PO BOX 7000 FORT DIX NJ 08640 SUSPENSION 7/20/2005BEST, BREKKE AKA SPADARO, BREKKE

RN 6/10/1981 35 WOODROW AVENUE FRANKLIN LAKES NH 03235 DISQUALIFICATION 2/20/2018

BETHEA, ALFREDA LPN 5/12/1951 1234 PROSPECT STREET TRENTON NJ 08638 SUSPENSION 10/20/2002BEUKAS, STEPHEN DMD 9/3/1965 1275677213 27 ROUTE 34 NORTH COLTS NECK NJ 07722 DEBARMENT 3/30/2014BEUKAS, STEPHEN DMD 9/3/1965 1275677213 MONMOUTH COUNTY

CORRECTIONAL INSTITUTE, 1 WATERWORKS ROAD

FREEHOLD NJ 07728 DISQUALIFICATION 10/18/2018

BEYNON-SERFASS, LEONOR

RN 12/11/1963 18 WILSON AVENUE CLARKS SUMMIT PA 18411 DISQUALIFICATION 11/30/2017

BEZOZA, HOWARD M. MD 9/3/1952 PO BOX 372 SADDLE RIVER NJ 07458 SUSPENSION 7/20/2003BHATTI, HAMID 10/3/1977 80 MILTON AVENUE, #1522 RAHWAY NJ 07065 DISQUALIFICATION 9/20/2012 9/10/2019BIENSTOCK, DOUGLAS DO 6/27/1966 1831151356 245 DIAMOND BRIDGE

AVENUEHAWTHORNE NJ 07506 DEBARMENT 12/16/2015

BIENSTOCK, DOUGLAS DO 6/27/1966 1831151356 245 DIAMOND BRIDGE AVENUE

HAWTHORNE NJ 07506 DISQUALIFICATION 5/12/2016

BILENKIN, ELANA 8/19/1969 242 COMUNITY CIRCLE OLD BRIDGE NJ 08857 DISQUALIFICATION 4/15/1998BINDER, RANDY RPH 2/19/1953 1972526572 FCI OTISVILLE, PO BOX 1000 OTISVILLE NY 10963 DISQUALIFICATION 8/20/2015 PERMANENT

BINDER, RANDY RPH 2/19/1953 1972526572 16 WINTER PLACE ABERDEEN NJ 07747 DISQUALIFICATION 9/20/2016 PERMANENTBIODIAGNOSTICS LAB SERVICES

1407923568 181 NEW STREET PARSIPPANY NJ 07054 SUSPENSION 1/21/2015

BIONDELLO JR., PHILIP 9/8/1966 41 CONCORD LANE BASKING RIDGE NJ 07920 DISQUALIFICATION 7/20/2017



14






EXPIRATION DATE

BIO-SCIENCE LAB, INC. 1000 WOODBRIDGE COURT WOODBRIDGE NJ 07095 DEBARMENT 3/20/2000

BISHARA, GIRGIS MD 12/23/1921 859 BRIGHTON PLACE OCEAN CITY NJ 08226 DISQUALIFICATION 1/17/1987 DECEASEDBITTNER, MELISSA C. RN 10/21/1976 436 RIVER DRIVE WESTVILLE NJ 08093 SUSPENSION 1/19/2005BLACKMAN, NOEL MD 12/18/1947 1720209521 MOSHANNON VALLEY CI, 555

GEO DRIVEPHILLIPSBURG PA 16866 DISQUALIFICATION 11/30/2017 PERMANENT

BLACKMAN, NOEL MD 12/18/1947 1720209521 MOSHANNON VALLEY CI, 555 GEO DRIVE

PHILLIPSBURG PA 16866 DISQUALIFICATION 3/26/2017 PERMANENT

BLANCO, ALEX DPM 2/21/1972 1881677987 180 LAFAYETTE AVENUE, APT. 12A

PASSAIC NJ 07055 DISQUALIFICATION 8/24/2017

BLANCO, LAZARO PHARM TECH

12/26/1990 401 46TH STREET, APT. 5 UNION CITY NJ 07087 DISQUALIFICATION 8/28/2017

BLANTON, MALEEK CHHA 8/13/1992 640 LINE STREET CAMDEN NJ 08103 DISQUALIFICATION 7/14/2017BLAU, SEYMOUR H. DPM 5/28/1923 36 COLLEGE DRIVE JERSEY CITY NJ 07305 SUSPENSION 11/20/2003BLEIMAN, MICHAEL MD 8/24/1961 1821086463 1100 ROUTE 72 WEST, SUITE

304MANAHAWKIN NJ 08050 SUSPENSION 1/27/2017 4/27/2017

BLOOMFIELD PHARMACY 154 BLOOMFIELD AVENUE NEWARK NJ 07104 DISQUALIFICATION 1/31/2000

BLOT, EDWARD MD 3/25/1941 274 NORTH CENTER STREET ORANGE NJ 07050 DEBARMENT 7/5/2000

BLUM, NOEL 74 TWIN RIVERS DRIVE EAST WINDSOR NJ 08561 DISQUALIFICATION 6/1/1993BLY, RODNEY 5/28/1965 4737 FRANKFORD AVENUE,

3RD FLPHILADELPHIA PA 19124 DISQUALIFICATION 11/20/2015

BLYN, CHARLOTTE MD 11/18/1928 1669700910 511 WINDING WAY MERION STATION PA 19066 DISQUALIFICATION 11/20/2015BMA MEDICAL LABORATORY

59-07 71ST AVENUE RIDGEWOOD NY 11385 SUSPENSION 10/20/2003

BOADU, JACOB RPH 9/23/1959 EUCLID TERRACE PARSIPPANY NJ 07054 SUSPENSION 8/20/2007BOAMAH, KWAKU MD 2/4/1957 1154413029 101 HAVEN WAY MORGANVILLE NJ 07751 DEBARMENT 6/7/2017 8/2/2019BOBADILLA, MARIA CHHA 6/2/1969 85 PRESIDENTIAL

BOULEVARD, APT. 2KPATERSON NJ 07522 DISQUALIFICATION 3/5/2018

BOBRYSHEVA, SVETLANA CHHA 3/8/1961 29 FOREST GARDENS DRIVE MATAWAN NJ 07747 DISQUALIFICATION 9/26/2017

BODINE, DENISE RN 7/5/1964 66 YORK STREET, APT. 12 LAMBERTVILLE NJ 08530 DISQUALIFICATION 5/25/2011



15






EXPIRATION DATE

BOEHM, GREGORY MD 6/4/1949 1972678894 26777 LORAIN AVENUE, SUITE 716

NORTH OLMSTEAD OH 44070 DISQUALIFICATION 11/20/2015 12/28/2021

BOGUSLAVSKIY, VADIM A & S IC 6/10/1948 1903 MADALINE DRIVE AVENEL NJ 07001 SUSPENSION 12/20/2001BOGUSLAVSKIY, VADIM A & S IC 6/10/1948 1903 MADALINE DRIVE AVENEL NJ 07001 DISQUALIFICATION 3/25/2002BOHUSLAWSKY, NINA RN 10/9/1970 PO BOX 4004 CLINTON NJ 08809 DISQUALIFICATION 2/20/2010BOISVERT, RAYMOND JOHN

RN 12/8/1961 2701 NW 23 BOULEVARD, APT. 225

GAINESVILLE FL 32605 DISQUALIFICATION 8/20/2015

BOND, CLIFTON MD 9/5/1956 418 JAMESTOWN COURT MOUNT LAUREL NJ 08054 DISQUALIFICATION 2/21/1992BONDAR, SOFIYA DDS 8/24/1954 1952355158 2815 COYLE STREET, APT.


BONETT, OLGA 3/7/1967 5105 N. PARK DRIVE PENNSAUKEN NJ 08109 SUSPENSION 4/29/2003BONILLA, CLEMY CHHA 4/17/1994 2809 YORKSHIP ROAD CAMDEN NJ 08104 DISQUALIFICATION 2/8/2017BONNELL, STEPHANIE RN 12/18/1974 165 DEY GROVE ROAD MONROE NJ 08831 SUSPENSION 2/20/2002BONSU, ACHIAA CHHA 1/20/1982 1414 BIRCHWOOD COURT NORTH BRUNSWICK NJ 08902 DISQUALIFICATION 7/14/2017 3/3/2020BONSU, KWADWO CHHA 8/5/1988 911 AZALEA DRIVE NORTH BRUNSWICK NJ 08902 DISQUALIFICATION 1/31/2017BONSU, NANA CHHA 3/4/1985 68 MYRTLE AVENUE IRVINGTON NJ 07111 DEBARMENT 3/6/2018BOODRAM, VERONA 10/31/1977 134 EVERGREEN PLACE 8TH EAST ORANGE NJ 07018 SUSPENSION 3/22/2006

BOONE, LESLIE RN 10/18/1961 122 SUMMIT AVENUE TRENTON NJ 08628 SUSPENSION 6/20/2002BORCHARDT, KAREN RN 1/18/1952 4145 MILL CREEK DRIVE NORTH CHARLESTON SC 29420 SUSPENSION 6/17/2004

BORGES, JOHN MANUEL 4/16/1964 550 BUCKINGHAM DRIVE PISCATAWAY NJ 08854 DISQUALIFICATION 8/20/2010BORNHOLDT, HAE SUK THERAPI

ST5/17/1958 PO BOX 1288 MCAFEE NJ 07428 SUSPENSION 9/19/2002

BORNSTEIN, KATHLEEN LPN 12/29/1963 136 73RD STREET NORTH BERGEN NJ 07047 SUSPENSION 2/19/2004BOROWEC, LAWRENCE MD 7/22/1952 202 STATESBURY AVENUE NEWFIELD NJ 08344 DISQUALIFICATION 12/1/1998BOROWEC, LAWRENCE MD 7/22/1952 202 STATESBURY AVENUE NEWFIELD NJ 08344 SUSPENSION 11/18/1997BORRELLI, HENRY DPM 5/22/1958 1902839830 49 PROSPECT STREET LITTLE FALLS NJ 07424 DEBARMENT 4/6/2010 10/27/2017BORTZ, AMANDA PHARM

TECH1/25/1985 13 SWEET BRIAR DRIVE SICKLERVILLE NJ 08081 DISQUALIFICATION 11/21/2016 4/5/2018

BOSTICK, MICHELLE CHHA 6/16/1962 87 TILLINGHAST STREET NEWARK NJ 07108 DISQUALIFICATION 2/20/2017BOTTENBLEY, CECIL J. DMD 6/6/1950 1245384304 16 FIRESIDE COURT WILLINGBORO NJ 08046 DISQUALIFICATION 4/9/1987



16






EXPIRATION DATE

BOUCHE, JASON 7/16/1984 6641 E. MEADOWLARK LANE PARADISE VALLEY AZ 85253 DISQUALIFICATION 5/20/2012

BOULOS-PLUDOWSKI, GEORGEANN

RPH 1/20/1958 493 RINGWOOD AVENUE PHILLIPSBURG NJ 08865 SUSPENSION 5/19/2005 3/11/2013

BOWICK, JUDY C. CHHA 9/1/1951 1503 BOND STREET ASBURY PARK NJ 07712 SUSPENSION 8/20/2002BOYD, DARRYL 1/27/1960 PO BOX 38, FCI FORT DIX NJ 08640 DISQUALIFICATION 7/18/2002BOYKIN, ASHLEE CHHA 5/9/1984 602 HARBOR LANE SICKLERVILLE NJ 08081 DEBARMENT 3/6/2018BOYKINS, TAMIKA CHHA 5/17/1989 235 ABLETT VILLAGE CAMDEN NJ 08105 DEBARMENT 5/16/2018BRABHAM, THEODORE J. 9/10/1951 14 HAZARD STREET ELIZABETH NJ 07208 DISQUALIFICATION 12/20/2001BRACEWORKS PROF ORTHODONTIST

288 HIGHWAY 35 SOUTH EATONTOWN NJ 07724 SUSPENSION 8/20/2003

BRACUTO, ANNMARIE RN 3/20/1962 1319 ST. GEORGE AVENUE RAHWAY NJ 07065 DISQUALIFICATION 9/12/2016BRADLEY, EARL B. MD 5/10/1953 1669414553 1181 PADDOCK ROAD SMYRNA DE 19977 DISQUALIFICATION 10/20/2012BRANCO, DOROTHY LPN 6/4/1969 1012 W. GENEVA STREET EGG HARBOR CITY NJ 08215 DISQUALIFICATION 5/11/2019BRANDT, DOUGLAS A. 9/7/1959 5 HOWARD STREET VERONA NJ 07044 DISQUALIFICATION 2/20/2011BRANDT, HERBERT L. RPH 10/15/1932 6 DEVONSHIRE DRIVE RANDOLPH NJ 07689 DISQUALIFICATION 2/20/2011BRANDT, JEFFREY M. 5/13/1957 24 CRESTVIEW LANE MOUNT ARLINGTON NJ 07856 DISQUALIFICATION 11/17/2011BRAUNSTEIN, MOSES 2404 BRONX PARKWAY BRONX NY 10458 DISQUALIFICATION 6/1/1993BRAVER, ALEXANDER MD 10/18/1950 1811098650 127 CROAK AVENUE STATEN ISLAND NY 10314 DISQUALIFICATION 7/20/2007BREEN, NICHOLAS DMD 10/2/1961 1730307836 7731 RUDDEROW AVENUE PENNSAUKEN NJ 08109 DISQUALIFICATION 8/18/1995 9/27/2013BREEN, NICHOLAS DMD 10/2/1961 1730307836 7731 RUDDEROW AVENUE PENNSAUKEN NJ 08109 DISQUALIFICATION 5/14/1996 9/27/2013BREIHOF, PETER 8/9/1970 51 COEYMAN AVENUE NUTLEY NJ 07110 DISQUALIFICATION 2/5/2019BRESSMAN, DANIELLE RN 1/16/1981 40 HARBORAGE AVENUE BAYVILLE NJ 08721 DISQUALIFICATION 1/29/2019BRETTLER, NORMAN AKA BRETTLER, NORBERT

2/3/1948 401 COUNTRY CLUB DRIVE CHERRY HILL NJ 08003 DISQUALIFICATION 5/12/2016

BREWINGTON, CYNTHIA CHHA 7/3/1962 379 MILLRIDGE ROAD CLEMENTON NJ 08021 DISQUALIFICATION 1/31/2017BRICK, ROGER MD 12/20/1949 31-33 WEST 11TH STREET NEW YORK NY 10026 SUSPENSION 12/15/2006BRIGHAM, STEVEN C. MD 8/29/1956 1306012539 1094 CORBRIDGE COURT VOORHEES NJ 08043 DISQUALIFICATION 6/20/2018BRINT, SAMUEL DO 1/6/1918 515 BIRD WAY CAMDEN NJ 08103 DISQUALIFICATION 12/15/1987BRISTOL, KENNETH RN 1/2/1951 PO BOX 931 FLAGSTAFF AZ 06002 SUSPENSION 10/19/2006BRITT, JANICE RN 2/4/1965 28 SCHOOL STREET SWANSEA MA 02777 DISQUALIFICATION 4/27/2019BRIZER, DAVID ALLEN MD 1/22/1953 1518181270 255 W 85TH STREET, APT. 5B NEW YORK NY 10024 DISQUALIFICATION 6/30/2014



17






EXPIRATION DATE

BRIZER, DAVID ALLEN MD 1/22/1953 1518181270 6766 108TH STREET, APT. A62

FOREST HILLS NY 11375 DISQUALIFICATION 2/20/2015

BROADNAX, DEITRICH 7/12/1965 347 BELLEVILLE AVENUE, #B8 BLOOMFIELD NJ 07003 DISQUALIFICATION 11/25/1998

BROADWAY MEDICAL GROUP

227 BROADWAY PATERSON NJ 07501 DISQUALIFICATION

BRODSKY, KONSTANTIN CHHA 1/1/1947 55 WEST 45TH STREET, FL 7R NEW YORK NY 10036 DEBARMENT 5/2/2017

BROOKHIM, ROBEN DDS 8/24/1958 444 MORRIS AVENUE ELIZABETH NJ 07208 SUSPENSION 8/20/2000BROOKHIM, ROBEN DDS 8/24/1958 120 LAWRENCE DRIVE SHORT HILLS NJ 07078 DISQUALIFICATION 5/20/2015BROOKMAN, HARVEY W. MD 3/20/1941 301 OXFORD VALLEY ROAD YARDLEY PA 19067 DISQUALIFICATION 4/13/1995

BROOKS JR., OSCAR COUNSELOR

11/8/1963 27 E VILLAGE OF STONEY ROAD

MAPLE SHADE NJ 08052 DISQUALIFICATION 4/17/1995

BROOKS, MAUREEN R. LPN 7/9/1954 110 THIRD AVENUE BELMAR NJ 07719 SUSPENSION 10/9/2003BROWN, ALEXANDRIA N. RN 12/15/1965 803 DAWN LANE WILLIAMSTOWN NJ 08094 SUSPENSION 5/19/2005BROWN, DANNY CHHA/C 8/15/1961 527 CENTRE STREET EASTON PA 18042 DISQUALIFICATION 8/6/2018 PERMANENTBROWN, DEANNA CHHA 12/17/1988 611 B. BINGHAM STREET NEPTUNE NJ 07753 DISQUALIFICATION 1/23/2018BROWN, DERVENT CHHA 9/20/1959 151 FIRST STREET ENGLEWOOD NJ 07631 DEBARMENT 1/26/2018BROWN, IMAN CHHA 10/20/1983 717 N. MICHIGAN AVENUE ATLANTIC CITY NJ 08401 DEBARMENT 7/14/2017BROWN, KAYDIA CHHA 8/24/1985 1033 SEWALL AVENUE ASBURY PARK NJ 07712 DISQUALIFICATION 1/31/2017BROWN, LAFONDA CHHA 5/20/1976 485 EAST 19TH STREET, APT.

#4-FPATERSON NJ 07524 DEBARMENT 10/26/2017

BROWN, ROGER H. DMD 5/12/1955 1457460305 601 ROUTE 206, UNIT 30 BELLE MEAD NJ 08844 DEBARMENT 5/27/2005BROWN. SAO LPN 10/30/1964 9 ALAN STREET WEST ORANGE NJ 07052 DEBARMENT 6/5/2017BROWN-COLEY, KELLI LPN 7/10/1967 88 WEST 6TH STREET BAYONNE NJ 07002 DISQUALIFICATION 10/11/2017BRUNELLE, ELIZABETH LPN 10/13/1950 5902 EAST 2ND STREET TUCSON AZ 85711 SUSPENSION 10/19/2006BRYANT-DERRICK, LPN 10/18/1967 107 DEAL AVENUE NEPTUNE NJ 07753 DISQUALIFICATION 9/12/2016BUCKLEY, MARIANNE LPN 1/3/1926 83 IRVING COURT TRENTON NJ 08610 SUSPENSION 5/20/2001BUITRAGO, CARMEN LPN 8/2/1975 412 CLIFF STREET, APT. 1 FAIRVIEW NJ 07022 DISQUALIFICATION 7/12/2018BULGER, PATRICE RN 2/16/1963 117 MILL CREEK ROAD BAYVILLE NJ 08721 DISQUALIFICATION 7/15/2002BULLARD, ANGELA CHHA 2/5/1989 268 E. 21ST STREET, 3RD FL. PATERSON NJ 07513 DISQUALIFICATION 12/26/2017



18






EXPIRATION DATE

BUNCH, LATITIA LPN 9/9/1971 212 S. 27TH STREET CAMDEN NJ 08105 SUSPENSION 2/20/2002BUNN, YAHMINAH CHHA 9/26/1983 22 GATLING COURT NEW BRUNSWICK NJ 08901 DISQUALIFICATION 5/2/2017BUONO, DONNA RN 10/17/1964 61 S. LOCUST AVENUE MARLTON NJ 08053 SUSPENSION 9/19/2003BURDETTE, KAYLA F. CHHA 10/26/1990 31 ISLAND AVENUE SEASIDE PARK NJ 08752 DISQUALIFICATION 11/14/2014BURGOS, LEALYNN CHHA 1/31/1994 636 BILLINGS AVENUE PAULSBORO NJ 08066 DISQUALIFICATION 1/31/2017BURKARD, JUDITH LPN 5/2/1956 320 7TH AVENUE, APT. 16 ASBURY PARK NJ 07712 DISQUALIFICATION 11/23/2009 11/23/2010BURKE, WILLIAM MD 8/3/1937 PO BOX 670 NEW VERNON NJ 07976 SUSPENSION 11/20/2006BURKES, JEFFREY DDS 7/21/1948 1073690137 176 LAKEWOOD AVENUE HO-HO-KUS NJ 07423 DISQUALIFICATION 2/19/2009BURKETT, EILEEN PHARM

TECH11/30/1952 1407 VIRGINIA COURT MARLTON NJ 08053 SUSPENSION 4/20/2011

BURNETT, RASHEEDAH CHHA 1/26/1983 860 SOUTH 11TH STREET, APT. 4-B

NEWARK NJ 07108 DISQUALIFICATION 1/31/2017

BURNS, MARGARET 12/9/1952 2429 WESTFIELD AVENUE SCOTCH PLAINS NJ 07076 SUSPENSION 9/19/2003BURRELL, TIARA CHHA 3/26/1993 141 STRANGER AVENUE GLASSBORO NJ 08028 DISQUALIFICATION 7/19/2019BURWELL-ADENIJI, LORIN CHHA 12/19/1987 1004 HIGH STREET BURLINGTON NJ 08016 DISQUALIFICATION 2/20/2017

BUSSEY, PAUL MD 10/22/1969 1356341424 1 MILL STREET WOODSTOWN NJ 08098 DEBARMENT 10/13/2015BUSSEY, PAUL MD 10/22/1969 1356341424 187 KIRSCHLING DRIVE SWEDESBORO NJ 08095 DEBARMENT 1/22/2016BUTT, ATIQ 2/2/1959 2524 FORD ROAD BRISTOL PA 19007 DISQUALIFICATION 6/15/2001BUTTERHOF, TRACY RN 8/13/1960 501 S. BERLIN AVENUE EGG HARBOR CITY NJ 08215 SUSPENSION 4/20/2003BUTTS, YOLANDA CNA 4/6/1988 600 PACIFIC AVENUE, APT.

102ATLANTIC CITY NJ 08401 DISQUALIFICATION 3/2/2020

BYADGI, CHETHAN MD 8/8/1963 1063537215 LACKAWANNA COUNTY PRISON, 1371 NORTH WASHINGTON AVENUE

SCRANTON PA 18509 DISQUALIFICATION 7/20/2017

BYAHATI, PRAMILA MD 4/15/1944 1841212800 200 EXCHANGE STREET, UNIT 317

PROVIDENCE RI 02903 DISQUALIFICATION 7/23/2020

BYERS, FAYE AKA BYERS, RAYMOND

R & B TRANS

2/6/1943 44 PALM STREET, FL. 2 NEWARK NJ 07106 DEBARMENT 10/14/2005

CABALEIRO, YODALIO MD 12/3/1930 3700 KENNEDY BOULEVARD UNION CITY NJ 07087 DISQUALIFICATION 4/18/1986

CABALERIO, THERESA 4611 BERGENLINE AVENUE UNION CITY NJ 07087 DISQUALIFICATION 6/1/1993CABAN, DESTINY CHHA 9/18/1996 105 BOYD STREET CAMDEN NJ 08105 DISQUALIFICATION 2/8/2017



19






EXPIRATION DATE

CABATIC, VIRGINIA C. RN 6/11/1940 14 SPARROW ROAD RANDOLPH NJ 07869 SUSPENSION 5/19/2005CABRERA, RAMON BRETON

6/29/1959 486 ZAMBORY STREET PERTH AMBOY NJ 08861 DEBARMENT 9/19/2011

CACERES, MARIO 8/26/1958 328 MARKET STREET CAMDEN NJ 08102 SUSPENSION 10/20/1998CACERES, MARIO 8/26/1958 328 MARKET STREET CAMDEN NJ 08102 SUSPENSION 10/5/2000CACI, FRANCIS R. DDS 2/18/1940 248 SOUTH SUMMIT AVENUE HACKENSACK NJ 07601 DISQUALIFICATION 12/8/1997 DECEASED

CACOILO, MARIA 10/31/1967 1150 AMBOY AVENUE EDISON NJ 08837 DISQUALIFICATION 4/29/2003CAI, PING DMD 11/15/1962 1275667362 22 SAGE STREET HOLMDEL NJ 07733 DISQUALIFICATION 9/10/2012 9/15/2017CALABRESE, ANGELO MD 6/12/1957 1891722237 FCI SCHUYKILL, PO BOX 759 MINERSVILLE PA 17954 DISQUALIFICATION 1/22/2016

CALABRESE, ANTHONY RN 12/28/1983 105 JOAN COURT JACKSON NJ 08527 DISQUALIFICATION 1/22/2020CALDERON, TANISHA CHHA 11/26/1977 108 N. 16TH EAST ORANGE NJ 07019 SUSPENSION 3/20/2002CALLAHAN, VICTORIA PHARM

TECH5/23/1979 130 FROST AVENUE PHILLIPSBURG NJ 08865 DISQUALIFICATION 7/21/2017 PERMANENT

CALVELO, ARSENIO C. RN 3/15/1953 13515 SCENIC GLADE DRIVE HOUSTON TX 77059 SUSPENSION 6/19/2003CAMACHO, OLGA CHHA 8/13/1969 176 KNAPP AVENUE CLIFTON NJ 07011 DISQUALIFICATION 1/17/2018CAMP, SUZANNE RN 5/18/1954 PO BOX 423 PORT ELIZABETH NJ 08348 SUSPENSION 10/21/2010CAMPANELLA-KAPLAN, DONNA

LPN 2/12/1970 1355 W. POINT AVENUE MAYS LANDING NJ 08330 DISQUALIFICATION 4/10/2018

CAMPBELL JR., HIGHLAND MD 11/26/1966 1043270143 1009 MEADOWVIEW LANE MONT CLARE PA 19453 DISQUALIFICATION 11/20/2015 12/18/2020

CAMPIONE JR., FRANK PA 3/10/1970 1598856924 431 STONEY POINT ROAD BRICK NJ 08733 DISQUALIFICATION 9/16/2016 2/19/2020CANALES JR., DELOVI 10/3/1966 11 ALBERT STREET TOMS RIVER NJ 08953 DEBARMENT 4/30/2010 4/30/2013CANARES, ALEXANDER RN 11/23/1977 60 BROOKSIDE AVENUE, APT.

2BSOMERVILLE NJ 08876 DISQUALIFICATION 5/2/2018

CANE, LAMONT NURSES AIDE

PO BOX 90431 CAMDEN NJ 08012 SUSPENSION 8/18/1997

CANNON, JEROME 1/20/1965 4221 NORTH 6TH STREET PHILADELPHIA PA 19140 DISQUALIFICATION 12/29/2015CANTAVE, MARIE CHHA 7/20/1979 1217 OCEAN AVENUE, APT. C-

12BRADLEY BEACH NJ 07720 DISQUALIFICATION 4/18/2017

CANTERMEN, LYNN RN 11/3/1975 518 N. HILDEBRAND AVENUE GLENDORA NJ 08029 DISQUALIFICATION 5/2/2018



20






EXPIRATION DATE

CAPACIO, RICHARD DC 10/3/1958 1245230929 99 ANNAPOLIS DRIVE SICKLERVILLE NJ 08081 SUSPENSION 12/20/2006CAPILLI, MICHAEL A. DC 5/14/1960 427 HOYT STREET LONG BRANCH NJ 07740 SUSPENSION 8/9/2001CAPITANO, PETER RPH 2/7/1955 FCI SCHUYLKILL, PO BOX 759 MINERSVILLE PA 17954 DISQUALIFICATION 11/20/2015

CAPO. LASARAH CHHA 9/22/1988 50-52 ROSA PARK BOULEVARD, APT. 5

PATERSON NJ 07501 DISQUALIFICATION 1/31/2017

CAPOBIANCO, LEO J. DO 3/19/1966 1063483097 7 CASTLE COURT RANDOLPH NJ 07860 DISQUALIFICATION 9/5/2002 6/8/2018CAPPIELLO, RAFAEL MD 7/20/1930 2704 BRIENZA WAY LAS VEGAS NV 89117 DEBARMENT 8/19/1999CAPRIOLA, EDWARD MD 7/20/1942 313 S. FRANK ROGERS HARRISON NJ 07029 SUSPENSION 12/20/2006 DECEASEDCARABALLA, CARLA CHHA 1/25/1958 742 EAST SEVENTH STREET PLAINFIELD NJ 07062 DISQUALIFICATION 6/13/2017 PERMANENTCARAGINE JR., PAUL J. MD 5/1/1945 1 SAWMILL ROAD KINNELON NJ 07504 DISQUALIFICATION 7/18/2001CARCHIA, ETTORE DC 8/21/1960 994 SANDY CIRCLE MANAHAWKIN NJ 08050 SUSPENSION 2/20/2006CARDENAS, PRESENTACION E.

RN/LPN 11/21/1953 274 BATH AVENUE, #22 LONG BRANCH NJ 07740 SUSPENSION 5/20/2001

CARDILLO, JOHN 7/18/1956 162 GARFIELD STREET BERKELEY HEIGHTS NJ 07922 SUSPENSION 9/4/2005CARDILLO, JOHN 7/18/1956 162 GARFIELD STREET BERKELEY HEIGHTS NJ 07922 DEBARMENT 5/20/2006CARDILLO, RICHARD C. MD 7/22/1955 1477520807 2893 BIRCH ROAD SUAMICO WI 54173 DEBARMENT 3/27/2002CARDINAL, PETER MD 11/29/1958 1104985142 520 WALNUT STREET, APT. 3 LEMOYNE PA 17043 DISQUALIFICATION 11/20/2015

CARDOSO SR., LUCIO MD 6/23/1958 1639119019 253 LAFAYETTE STREET NEWARK NJ 07105 SUSPENSION 2/22/2012CARDOSO SR., LUCIO MD 6/23/1958 1639119019 FCI FORT DIX, PO BOX 38 FORT DIX NJ 08640 DISQUALIFICATION 2/3/2014CAREPOINT MEDICAL 1396744694 4860 COX ROAD, SUITE 300 GLEN ALLEN VA 23060 DISQUALIFICATION 11/20/2015CAREY JR., CHARLES B. 2/1/1979 218 BRIANT PARK DRIVE SPRINGFIELD NJ 07081 DISQUALIFICATION 5/20/2015CARIDAD, MICHELLE CHHA 1/22/1971 10 BROOKSIDE COURT TOMS RIVER NJ 08753 DISQUALIFICATION 2/8/2017CARIDEO, IDA MD 2/18/1957 1578842977 7 MALKE DRIVE WAYSIDE NJ 07712 DISQUALIFICATION 6/7/1999 8/1/2012CARINO, JOVY 12/15/1964 37 JAMES STREET BLOOMFIELD NJ 07003 SUSPENSION 5/29/2009CARLSON, LILLIAN MAE RN 8/5/1956 275 HIGH STREET APT. Q334 GLASSBORO NJ 08028 DISQUALIFICATION 6/18/2009

CARLUCCI JR., WILLIAM A. RPH 9/7/1943 1902120363 FCI FORT DIX, PO BOX 38 FORT DIX NJ 08640 DEBARMENT 9/25/2014CARLUCCI, ROBERT A. RPH 9/7/1943 1639493091 PO BOX 759 MINERSVILLE PA 17954 DEBARMENT 9/25/2014CARMENATY, ANTHONY LPN 4/13/1991 28 SUMMER STREET, APT.

B11PASSAIC NJ 07055 DISQUALIFICATION 5/25/2019

CARMONA, ALICE Y. 12/9/1957 78 DAWN STREET VINELAND NJ 08302 DEBARMENT 10/23/2000CARR, JOEL R. DO 1/1/1960 1275586489 8 JASMINE ROAD LUMBERTON NJ 08048 SUSPENSION 3/2/2011



21






EXPIRATION DATE

CARR, PATRICIA 8/1/1947 PO BOX 91 BROWNS MILLS NJ 08015 DISQUALIFICATION 7/19/2001CARRION, NANCY CHHA 7/18/1979 76 ZABRISKIE STREET JERSEY CITY NJ 07307 DEBARMENT 3/5/2018CARRION, SARAH CHHA 7/21/1971 1086 KENYON AVENUE PLAINFIELD NJ 07060 DEBARMENT 8/9/2018CARROLL, KIMBERLY J. LPN 7/3/1964 18 LEE AVENUE HADDONFIELD NJ 08033 DISQUALIFICATION 8/18/2011CARSON, YOLANDA CHHA 11/21/1968 65 DALES AVENUE, APT. 1137 JERSEY CITY NJ 07306 DISQUALIFICATION 1/31/2017

CARTER, DARRICKA C. DPM 1/1/1965 2505 ST. REGIS DRIVE RICHMOND VA 23236 DISQUALIFICATION 7/20/2010CARUSO, EDMUND M. DMD 7/30/1958 1811132442 2275 KENNEDY BOULEVARD JERSEY CITY NJ 07304 DISQUALIFICATION 11/10/1994

CASAS, JOSE MD 12/23/1933 215 PASSAIC AVENUE PASSAIC NJ 07055 DEBARMENT 5/24/1999CASAVINA, PHILIP 5/11/1929 244 KNOX AVENUE CLIFFSIDE PARK NJ 07650 DISQUALIFICATIONCASCIO, DANIEL RN 3/5/1956 17 SEGUR STREET DOVER NJ 07801 SUSPENSION 5/20/2002CASTANEDA, JOSE E. APN 11/3/1974 1699840264 1925 PACIFIC AVENUE ATLANTIC CITY NJ 08401 SUSPENSION 2/22/2012CASTANEDA, JOSE E. APN 11/3/1974 1699840264 194 E. 7TH STREET CLIFTON NJ 07011 DISQUALIFICATION 1/26/2015CASTANON, ROBERTO 5/1/1947 555 GEO DRIVE PHILLIPSBURG PA 16866 DISQUALIFICATION 9/16/2011CASTELLANO, DOLORES PASSAIC

FAMILY MEDICAL

4/8/1949 4300 SW 57TH STREET MIAMI FL 33155 SUSPENSION 6/17/2004

CASTILLO, AL JEHDD CHHA 7/16/1986 170 32ND WEST BAYONNE NJ 07002 DISQUALIFICATION 6/28/2018CASTILLO, HECTOR L. MD 4/18/1956 1528198124 1000 MADISON AVENUE PATERSON NJ 07501 DEBARMENT 2/19/2012 CASTILLO, STEVEN A. DDS 4/21/1962 1134342017 PO BOX 16421 JERSEY CITY NJ 07306 DISQUALIFICATION 5/5/1997CATANIA, RAYMOND DO 11/15/1961 1023094711 5 BRIARWOOD DRIVE EAST WARREN NJ 07059 DISQUALIFICATION 4/16/2021CATANZARO, DANIEL DC 10/19/1959 28 ETOWAH RIDGE DRIVE,

SWCARTERSVILLE GA 30120 SUSPENSION 12/20/2005

CATANZARO, VINCENT F. MD 5/22/1947 560 MAIN STREET ALLENHURST NJ 07711 DISQUALIFICATION 6/1/1993 DECEASEDCATHERS, THOMAS LPN 2/19/1972 707 BURLINGTON AVENUE DELANCO NJ 08075 DISQUALIFICATION 4/6/2019CAVALLARO, KEVIN RN 3/27/1986 630 SALEM AVENUE FRANKLINVILLE NJ 08322 DISQUALIFICATION 5/11/2019 PERMANENTCAVALLI, DEAN 762 BROADWAY CAMDEN NJ 08103 DISQUALIFICATIONCAVE, SANDY 3/10/1972 109 BOBWHITE ROAD ROYAL PALM BEACH FL 33411 DISQUALIFICATION 5/20/2012CECE, ANGELO DMD 5/25/1957 1033396593 566 NYE AVENUE IRVINGTON NJ 07111 DISQUALIFICATION 1/19/1996CEDENO, HUMBERTO RPH 2/11/1925 601 ELIZABETH AVENUE ELIZABETH NJ 07206 DISQUALIFICATION 5/3/1984CENTRAL DIAGNOSTICS LAB

256 SMITH STREET PERTH AMBOY NJ 08861 DISQUALIFICATION 5/8/1989



22






EXPIRATION DATE

CENTRAL JERSEY MENTAL CENTER

525 PARK AVENUE PLAINFIELD NJ 07067 DISQUALIFICATION

CENTRELLI, MARC DC 8/1/1960 176 ALPINE TRAIL SPARTA NJ 07871 SUSPENSION 7/21/2008CHA, DONG S. MD 5/1/1938 608 S. BROAD STREET WOODBURY NJ 08096 DISQUALIFICATION 12/1/1998CHACK, JOEL DO 3/11/1956 1093739096 5 GWEN COURT CHERRY HILL NJ 08003 DISQUALIFICATION 8/13/2011 1/6/2012CHACKER, JASON PA 1/13/1983 1609058916 1030 DOMINO LANE WARMINSTER PA 18974 DISQUALIFICATION 7/10/2020CHAI, CHRISTINA RPH 8/20/1984 1689997835 2461 LEIGHTON STREET FORT LEE NJ 07024 DISQUALIFICATION 3/24/2016CHAIKEN, BARBARA LCSW 4/8/1952 1871768465 419 OTISCO DRIVE WESTFIELD NJ 07090 DISQUALIFICATION 6/1/1993CHAM, WILLIAM C. MD 8/15/1938 11 HICKORY DRIVE CHESTER TOWNSHIP NJ 07930 SUSPENSION 8/29/1997CHAMBERS, CAROL CHHA 9/25/1956 1022 STUYVESANT AVENUE IRVINGTON NJ 07111 SUSPENSION 1/20/2004CHAMPION, MARY MARGARET

RN/CHHA

9/26/1963 91 MOUNT AIRY AVENUE, SOUTH

EGG HARBOR NJ 08234 SUSPENSION 6/20/2005 6/11/2013

CHANDLER, BRYAN K. 6/15/1967 10 ELLINGTON STREET, #1 EAST ORANGE NJ 07017 DISQUALIFICATION 8/28/2008CHANDLER, CHARLES PA 10/11/1958 1417996901 219 N. WALNUT STREET, FL. 1 EAST ORANGE NJ 07017 DISQUALIFICATION 11/4/2009

CHANSKY, CHRISTINE MD 8/19/1968 1508125600 820 NORTH AVENUE WESTFIELD NJ 07090 DISQUALIFICATION 3/20/2018CHAPLAN, ABRAHAM MD 11/17/1929 384 NORTH WOODLAND

STREETENGLEWOOD NJ 07631 DISQUALIFICATION 6/1/1993

CHARLES, ESTHER CHHA 7/22/1987 380 UNION AVENUE IRVINGTON NJ 07111 DISQUALIFICATION 3/6/2018CHATMON, ALTON RPH 4/10/1970 1790091742 RR8, BOX 370 BRIDGETON NJ 08302 DEBARMENT 3/3/2017CHAUDHRY, YASMIN T. 1/18/1962 333 NORTH BROAD STREET ELIZABETH NJ 07028 SUSPENSION 7/21/1997CHEESE, EPHONIA CHHA 11/15/1989 18 PATRIOT LANE WILLINGBORO NJ 08046 DISQUALIFICATION 5/16/2018CHEN, BONNIE MD 1/14/1964 1750373486 243 HORSENECK ROAD FAIRFIELD NJ 07004 DISQUALIFICATION 8/12/2018 PERMANENTCHEN, KENNETH H. MD 5/23/1937 244 BROADWAY NEWARK NJ 07104 SUSPENSION 5/7/1999CHEN, TAN MD 6/10/1945 12 LORRAINE DRIVE PINE BROOK NJ 07058 DISQUALIFICATION 11/5/1999CHERVIN, ARON 7/18/1947 36 LAKE DRIVE NORTH BRUNSWICK NJ 08902 DISQUALIFICATION 2/11/2016CHESTON, EBONY CHHA 11/17/1981 33 NEWELL AVENUE TRENTON NJ 08618 DISQUALIFICATION 3/6/2018CHHADEH, AHED 3/25/1974 401 NEW BRUNSWICK AVE.,

APT 221EAST BRUNSWICK NJ 08816 DISQUALIFICATION 11/21/2016

CHIAPPETTA, THERESA 7/6/1974 8 STEINHARDT AVENUE OLD BRIDGE NJ 08857 DEBARMENT 9/15/2008CHIAPPETTA, THERESA 7/6/1974 8 STEINHARDT AVENUE OLD BRIDGE NJ 08857 DISQUALIFICATION 11/12/2009CHICCO, LUKE #65503-050

3/11/1973 FCI FAIRTON, PO BOX 420 FAIRTON NJ 08320 DISQUALIFICATION 2/5/2019



23






EXPIRATION DATE

CHIKOWSKI, JOHN RN 12/20/1980 121 WEST 29TH STREET, 2ND FL

BAYONNE NJ 07002 DISQUALIFICATION 10/24/2018 4/9/2019

CHILDREN'S DENTAL CENTER

1992974406 3700 KENNEDY BOULEVARD UNION CITY NJ 07087 DEBARMENT 9/15/2017

CHILLEMI, SALVATORE 7/10/1962 29 BERKSHIRE DRIVE SEWELL NJ 08080 DISQUALIFICATION 6/10/2011CHIRUMAMILLA, RAMABU

RPH 212 E. PITTSBURGH AVENUE WILDWOOD CREST NJ 08260 DISQUALIFICATION 3/11/1985

CHIZHOV, ELLA 12/24/1946 200 WINSTON DRIVE #C1104 CLIFFSIDE PARK NJ 07010 SUSPENSION 7/21/2008

CHIZHOV, SERGEY 6/12/1946 200 WINSTON DRIVE CLIFFSIDE PARK NJ 07010 DISQUALIFICATION 9/20/2007CHLOROS, STACY LPN 6/11/1974 323 GILL LANE ISELIN NJ 08830 SUSPENSION 5/18/2006CHOI, JEHEE RN 11/27/1965 31 PINE RIDGE LANE MANSFIELD CENTER CT 06250 DISQUALIFICATION 3/27/2018CHRISTENSEN, CYNTHIA RN 12/22/1962 20 SKYLINE DRIVE HAZLET NJ 07730 SUSPENSION 10/18/2001CHRISTJOHN, COLLEEN M. LPN 10/27/1964 CORSON ROAD SOUTH SEAVILLE NJ 08246 DISQUALIFICATION 8/11/2007CHRISTMAS, ARTHUR 6/7/1978 66 NORTH 11TH STREET NEWARK NJ 07107 DEBARMENT 6/16/2006CHRISTPHONTE, CAIRY CHHA 5/27/1962 1976 OSTWOOD TERRACE UNION NJ 07083 DISQUALIFICATION 9/9/2019 PERMANENTCHU, ALICE MD 6/6/1957 1962513366 1512 PALISADE AVENUE,

APT. 6PFORT LEE NJ 07024 DISQUALIFICATION 9/24/2019

CHUDRY, RAZA 4/6/1959 RD #5 FEDERAL PRISON LEWISBURG PA 17837 SUSPENSION 9/19/2002CHUGH, JAGDISH MD 12/1/1953 1609980366 1 CORINE COURT LONG VALLEY NJ 07853 DISQUALIFICATION 12/2/2019CHUKWUANI, ROSETTA CHHA 2/5/1962 3 LISZKA LANE SAYREVILLE NJ 08872 SUSPENSION 2/28/2009CHULAK, GENADY 9/4/1955 242 COMMUNITY CIRCLE OLD BRIDGE NJ 08857 DISQUALIFICATION 4/15/1996CHUNMUANG, PRASERT MD 5/15/1942 401 DEVONSHIRE PLACE FRANKLIN LAKES NJ 07417 DISQUALIFICATION 6/14/1993CHUPREVICH, EILEEN D. RN 11/15/1948 8 STANTON PLACE BUTLER NJ 07405 SUSPENSION 1/20/2003CIALLELLA, GINA AKA GARCEN, GINA

DC 4/14/1962 57 GREEN STREET WOODBRIDGE NJ 07095 DISQUALIFICATION 3/24/2000

CICCONE, GREGORY 12/22/1976 5 WATERS EDGE DRIVE LITTLE EGG HARBOR NJ 08087 SUSPENSION 5/15/2005CICERO, BARBARA RN 6/12/1937 91 LINCOLN AVENUE SOMERVILLE NJ 08876 SUSPENSION 8/20/2001CICERO, RALPH DDS 5/8/1944 1740449305 245 BALDWIN STREET SUCCASUNNA NJ 07876 DEBARMENT 3/6/2014CICERON, ANDRE MD 11/12/1944 1265526586 621 BANNING AVENUE NORTHFIELD NJ 08225 DISQUALIFICATION 2/8/2019 PERMANENTCITILAB CORPORATION 333 NORTH BROAD STREET ELIZABETH NJ 07028 SUSPENSION 12/1/1998CLACKLEY, MACK O. LPN 3/9/1962 PO BOX 150 DELMONT NJ 08314 SUSPENSION 9/20/2001CLAPPER, STEPHANIE LPN 11/19/1979 169 NAUTILUS MANAHAWKIN NJ 08050 DISQUALIFICATION 2/26/2010CLARK, INDIA CHHA 8/24/1989 5 SECOND AVENUE TOMS RIVER NJ 08757 DISQUALIFICATION 7/14/2017 5/6/2021



24






EXPIRATION DATE

CLARK, JAMES 9/26/1955 380 MOUNTAIN ROAD #12 UNION CITY NJ 07087 SUSPENSION 9/27/2007CLARK, JOVONNE CHHA 12/1/1983 1605 SEWALL AVENUE ASBURY PARK NJ 07712 DISQUALIFICATION 8/22/2017CLARK, KEVIN 9/16/1956 537 TRINITY PLACE WESTFIELD NJ 07090 SUSPENSION 10/5/2009CLARK, NORMAN L. MD 7/14/1952 5 TARA DRIVE PARSIPPANY NJ 07054 SUSPENSION 3/2/1999CLARK, NYKEBA CHHA 4/7/1980 807 N. INDIANA AVENUE ATLANTIC CITY NJ 08401 DEBARMENT 1/24/2018CLARK, RAYONNE 9/25/1979 844 CENTRE STREET TRENTON NJ 08611 SUSPENSION 7/20/2003CLARK, RAYONNE 9/25/1979 844 CENTRE STREET TRENTON NJ 08611 DISQUALIFICATION 8/13/2003CLARKE, KIRK CHHA 10/7/1967 218 YOUNGS ROAD TRENTON NJ 08619 DISQUALIFICATION 7/30/2019 PERMANENTCLARKE, MICHELLE CHHA 5/27/1971 75 NORTH WALNUT STREET,

APT. 6CEAST ORANGE NJ 07017 DISQUALIFICATION 1/30/2017 PERMANENT

CLAVIJO, LAURA RN 7/5/1981 908 CLARK CIRCLE FLEMINGTON NJ 08822 DISQUALIFICATION 8/28/2017CLEMENTE, JOHN MD 4/11/1955 1982933271 20 PILGRIM WAY COLTS NECK NJ 07722 DEBARMENT 11/29/2015CLEMENTE, JOHN MD 4/11/1955 1982933271 20 PILGRIM WAY COLTS NECK NJ 07722 DISQUALIFICATION 4/20/2015CLEMMENTS, RALPH W. MD 11/16/1923 7304 CENROSE CIRCLE WESTWOOD NJ 07675 DEBARMENT 9/12/2008CLIN-PATH LABORATORY, INC.

626 N. 38TH STREET BELLEVILLE IL 62223 DISQUALIFICATION 6/4/1997

COBB, ROY MD 3/3/1957 1548350556 504 SUMMIT AVENUE MAPLEWOOD NJ 07040 DISQUALIFICATION 6/5/2017 PERMANENTCOBB, WILLIAM A. MD 10/20/1942 1679666903 2 WEST RIVER STYX ROAD HOPATCONG NJ 07843 DEBARMENT 3/16/2011 PERMANENTCOCCO, KRISTEN RN 4/22/1975 44 SYRACUSE DRIVE CHERRY HILL NJ 08056 DISQUALIFICATION 6/5/2017CODDINGTON, DE'LYNNE CHHA 12/15/1992 904 MAIN STREET BRADLEY BEACH NJ 07720 DISQUALIFICATION 11/8/2017

COHEN, BARRY E. 5/19/1953 6326 NW 80TH TERRACE POMPANO BEACH FL 33067 SUSPENSION 3/20/2006COHEN, JUDAH L. MD 8/31/1953 1000 GALLOPING HILL ROAD UNION NJ 07083 DISQUALIFICATION 4/24/1998

COHEN, ROBERT G. RN/APN 11/16/1950 51 KRISTEN COURT MATAWAN NJ 07747 DISQUALIFICATION 3/24/2003COHEN, WENDY E. MD 3/23/1944 1619024056 151 N. DEAN STREET ENGLEWOOD NJ 07631 SUSPENSION 5/10/2012 DECEASEDCOLADONATO, JOSEPH MD 5/28/1943 9760 EVERGREEN AVENUE SEAFORD DE 19973 DEBARMENT 2/3/2006COLBERT, DONNA CHHA 2/24/1956 183 ROUTE 35 WALL TOWNSHIP NJ 07719 DISQUALIFICATION 7/14/2017 PERMANENTCOLEMAN, BARBARA CHHA 3/8/1950 81 LINCOLN PARK, APT. 5B NEWARK NJ 07102 DISQUALIFICATION 1/31/2017COLEMAN, BETH RN 11/14/1975 1598919466 12 NORTH ELMIRA STREET ATHENS PA 18810 DISQUALIFICATION 5/12/2016COLETTI, ROGER MD 12/22/1945 1770508053 324 CAPTAINS CL. LEWES DE 19958 DISQUALIFICATION 1/5/2018 PERMANENTCOLEY, CHERYL CHHA 3/16/1994 17 NORTH 3RD STREET PATERSON NJ 07522 DISQUALIFICATION 1/22/2018COLLIER, BERT D. MD 12/6/1947 4933 N. WILDWOOD AVENUE MILWAUKEE WI 53217 DEBARMENT 5/29/2001 9/20/2013



25






EXPIRATION DATE

COLLIER, KENYA CHHA 9/19/1980 708 THIRD AVENUE, APT. 13-B

ASBURY PARK NJ 07712 DISQUALIFICATION 1/31/2017

COLLIER, KISHA CHHA 7/20/1990 54 FEDERAL COURT GALLOWAY NJ 08205 DISQUALIFICATION 5/2/2017COLLINS, JEAN RN 6/10/1957 218 COPELAND AVENUE LYNDHURST NJ 07071 DISQUALIFICATION 4/24/2018COLON, KAREN L. LPN 11/29/1973 1020 MCGUIRE DRIVE TOMS RIVER NJ 08753 SUSPENSION 6/20/2005COLON-TORRES, FRANCIS M.

CHHA 3/28/1973 437 STUYVESANT AVENUE IRVINGTON NJ 07111 SUSPENSION 11/7/2008

COMESANAS, MARIO MD 11/25/1955 1508922659 COLUMBIA TURNPIKE FLORHAM PARK NJ 07932 DISQUALIFICATION 8/10/2007COMPAS, JEAN CLAUDE MD 11/6/1948 1720178148 255 EASTERN PARKWAY,

APT. D3BROOKLYN NY 11238 DISQUALIFICATION 7/20/2015

COMRIE, SHIRLEY M. CHHA 7/22/1957 7 DUFFELD DRIVE TRENTON NJ 08628 SUSPENSION 7/18/2002CONARD, MICHELLE LPN 3/26/1955 16 ELDRIDGE AVENUE TRENTON NJ 08648 DISQUALIFICATION 7/20/2009CONDON, MARJORIE MD 3/26/1960 329 FRANKLIN AVENUE RIDGEWOOD NJ 07450 DEBARMENT 11/2/2019CONNERS, LAURA LPN 6/9/1976 11 FENWAY ROAD HAMILTON NJ 08620 SUSPENSION 3/20/2002CONOVER, WILLIAM S. LPN 7/23/1965 225 RUTLAND AVENUE MOUNT HOLLY NJ 08060 SUSPENSION 5/20/2004CONTE, SALVATORE MD 9/25/1964 1174688493 NEW YORK RRM, PO BOX


CONTEH, AMARA S. MD 8/10/1943 3 OLD TAPPAN ROAD OLD TAPPAN NJ 07675 SUSPENSION 9/20/2007CONTI, VINCENT MFT 1/20/1935 1023189644 180 PROSPECT AVENUE MORRIS PLAINS NJ 07950 DISQUALIFICATION 9/23/2016COOPER STREET PSYCHIATRIC GROUP

301 COOPER STREET CAMDEN NJ 08012 DISQUALIFICATION 5/2/1990

COPLIN, GEORGE J. MD 1/23/1908 528 EAST JERSEY STREET ELIZABETH NJ 07206 DISQUALIFICATION 6/1/1993 DECEASEDCOPPOLA, KELLY AKA FURLONG, KELLY

PHARM TECH

3/21/1985 52 CORNELL DRIVE HAZLET NJ 07730 DISQUALIFICATION 9/23/2016

CORNELY, MICHAEL P. DC 12/11/1962 1326199803 6650 BROWINING ROAD MERCHANTVILLE NJ 08109 DISQUALIFICATION 12/1/1998CORREA-HUNTER, LOUISA DDS 6/17/1965 372 FOREST AVENUE PARAMUS NJ 07652 SUSPENSION 10/22/2010CORSON, KENNETH E. MD 5/12/1904 5 SOUTH MYRTLE STREET VINELAND NJ 08360 DISQUALIFICATION DECEASEDCORTEZ, JESSICA CHHA 4/21/1983 114 EDWARDS AVENUE LANDISVILLE NJ 08326 DISQUALIFICATION 9/6/2017COSTA, LAWRENCE J. 4/25/1948 441 PENN AVENUE FORKED RIVER NJ 08731 DISQUALIFICATIONCOSTIGAN, KEVIN LCSW 8/26/1955 132 FRANKLIN AVENUE, APT.

2LONG BRANCH NJ 07740 SUSPENSION 3/21/2000

COSTINO JR., JOHN DO 7/22/1944 1811978414 404 SURF AVENUE WILDWOOD NJ 08260 DISQUALIFICATION 8/18/2011



26






EXPIRATION DATE

COTTRELL, LISA L. CHHA 8/12/1963 290 ROUTE 9 NORTH, APT C5 WARETOWN NJ 08758 DISQUALIFICATION 9/30/2010

COUCH FISHER, SUSAN CHHA 10/5/1955 10 PLACID LANE WILLINGBORO NJ 08046 DISQUALIFICATION 2/8/2017COUGHLIN, CATHERINE K. RN 8/29/1956 PO BOX 22 LIMESTONE PA 16234 DISQUALIFICATION 9/18/2009COULTON, DIANE LPN 8/7/1961 272 BIRCH DRIVE LEVITTOWN PA 19054 DISQUALIFICATION 9/13/2018COVERDALE, JULIE ANN RN 8/3/1962 909 CINNAMINSON AVENUE PALMYRA NJ 08065 SUSPENSION 4/20/2003

COVILLE, FREDERICK A. MD 9/29/1957 1679728307 230 N. MAPLE AVENUE MARLTON NJ 08050 DEBARMENT 4/17/1997 8/16/2012COVILLE, FREDERICK A. MD 9/29/1957 1679728307 51-37 HAVENUEN AVENUE OCEAN CITY NJ 08226 DISQUALIFICATION 10/26/1998 8/16/2012COVONE, DOMINICK 7/14/1949 FCI FORT DIX, BOX 38 FORT DIX NJ 08640 DISQUALIFICATION 10/18/2001COWAN JR., JAMES MD 3/19/1944 1063527026 572 WEST SADDLE RIVER

ROADRIDGEWOOD NJ 07450 DISQUALIFICATION 9/20/2016 PERMANENT

COWAN JR., JAMES MD 3/19/1944 1063527026 28 W. 3RD STREET, APT. 1347 SOUTH ORANGE NJ 07079 DISQUALIFICATION 12/6/2017 PERMANENT

COWAN, MARYANNE LCSW 4/20/1954 572 WEST SADDLE RIVER ROAD

RIDGEWOOD NJ 07450 DISQUALIFICATION 12/21/2016 DECEASED

COWINS, KIMBLIN CHHA 3/20/1960 75 SHADY LANE HAMBURG NJ 07419 DISQUALIFICATION 9/20/2019 PERMANENTCOWINS, KIMBLIN LPN 3/20/1960 75 SHADY LANE HAMBURG NJ 07419 DISQUALIFICATION 9/20/2019 CRAPANZANO SR., PETER DDS 1/16/1950 1861566960 46 VILLAGE COURT HAZLET NJ 07730 SUSPENSION 4/26/2011

CRAWFORD, KENNETH CNA 10/13/1962 B-8 ABBINGTON DRIVE PHILLIPSBURG NJ 08865 DISQUALIFICATION 4/6/2006CRAWFORD, KENNETH CNA 10/13/1962 199A FIDDLER ELBOW ROAD PHILLIPSBURG NJ 08865 SUSPENSION 8/20/2006

CRAY, JASON E. COTTAGE AIDE

7/8/1969 WARREN COUNTY JAIL BELVIDERE NJ 07823 DISQUALIFICATION 8/21/2000

CRESTA, NICOLE AKA RIVERA, NICOLE

RN 2/11/1983 2009 KICKAPOO TERRACE VINELAND NJ 08361 DISQUALIFICATION 3/28/2017

CRISCITO, MARIO MD 5/22/1939 1063411957 32 CHELSEA DRIVE LIVINGSTON NJ 07039 DISQUALIFICATION 7/1/2017 PERMANENTCRISSIEN, CINDY 3/4/1982 78 FORNELIOUS AVENUE CLIFTON NJ 07013 SUSPENSION 1/18/2007CRITCHFIELD, CYNTHIA AKA SULLIVAN, CYNTHIA

RPH 6/12/1966 PIN OAK COURT SHAMONG NJ 08088 SUSPENSION 4/20/2008 6/15/2017

CROCKER JR., KENNETH 12/11/1975 15 VIOLA AVENUE LEONARDO NJ 07737 DEBARMENT 7/17/2009 7/17/2014CROMARTIE, CHERISE CHHA 10/12/1976 25 RONALD ROAD LAKEWOOD NJ 08701 DEBARMENT 7/19/2018



27






EXPIRATION DATE

CRON, EVA RN 5/18/1944 31 CHERRY STREET WARWICK NY 10990 SUSPENSION 9/27/2007CROUSE, FARRELL R. MD 9/20/1932 1386795292 101 NORTH MAIN STREET WOODSTOWN NJ 08098 DEBARMENT 3/18/2015CROWDER, CLAXTON L. MD 7/1/1942 115 ASHBY COURT MOUNT LAUREL NJ 08054 DISQUALIFICATION 1/13/2006CROWLEY, TERRI RN 7/27/1959 5 THOREAU ROAD HAMILTON SQUARE NJ 08690 DEBARMENT 11/13/2017CRUCIANI, RICARDO MD 7/22/1954 1881615268 77 HUDSON STREET, APT.

4401JERSEY CITY NJ 07302 DISQUALIFICATION 4/16/2018 PERMANENT

CRUZ, ANGELICA CHHA 5/15/1990 2566 SOUTH 8TH STREET CAMDEN NJ 08104 DISQUALIFICATION 7/14/2017CRUZ, DELIA CHHA 1/19/1988 3 RAY PLACE FAIRFIELD NJ 07004 DEBARMENT 3/5/2018CRUZ, EDNA CHHA 1/27/1980 PO BOX 535 VINELAND NJ 08362 DISQUALIFICATION 1/31/2017CRUZ, JAHAIRA CHHA 8/28/1985 559 BAILEY STREET CAMDEN NJ 08102 DISQUALIFICATION 5/2/2017CRUZ, MARIA C. 4/21/1963 128-65 MCCARTHY CIRCLE PHILADELPHIA PA 19154 DEBARMENT 12/5/2003CRUZ-SLEDGE, ANICIA 12/28/1961 13 TREMONT STREET, APT. 2 IRVINGTON NJ 07111 DEBARMENT 3/3/2015

CUETO, PAOLA CHHA 7/5/1994 619 THIRTY-EIGHTH STREET UNION CITY NJ 07087 DISQUALIFICATION 10/20/2017

CUFFE, MAXINE RN 9/26/1959 33 GREENBROOK DRIVE BLOOMFIELD NJ 07003 DISQUALIFICATION 3/3/2017 8/22/2019CUI, XIN CHHA 10/17/1968 119 S. ADELAIDE LANE HIGHLAND PARK NJ 08904 DISQUALIFICATION 4/24/2008CULLEN, CHARLES RN 2/22/1960 PO BOX 861 TRENTON NJ 08625 SUSPENSION 1/18/2007CULLEN, KENNETH 8/16/1952 100 MARSHALL AVENUE TUCKERTON NJ 08087 SUSPENSION 1/19/2010CUNNINGHAM, MICHAEL D.

MD 11/10/1951 PO BOX 505 GLEN SPEY NY 12737 SUSPENSION 9/19/2002

CUPO, DAWN LPN 10/21/1961 129 ADELPHIA ROAD FARMINGDALE NJ 07727 SUSPENSION 6/20/2001CUPOLO, STACY J. DENTAL

HYGIENIST

1/5/1962 897 INVERNESS COURT, APT. A

LAKEWOOD NJ 08701 SUSPENSION 6/20/2005

CURETON, WILLIE T. 8/12/1969 61 CHELSEA AVENUE NEWARK NJ 07106 DISQUALIFICATION 5/27/2011CURETON, WILLIE T. 8/12/1969 5 UNAMI LANE SCOTCH PLAINS NJ 07076 DISQUALIFICATION 2/23/2009CURRY JR., CHARLES M. MD 6/3/1943 816 BURNT MILLS ROAD OLDWICK NJ 08858 DISQUALIFICATION 12/1/1998CUSTIS, KEVIN MD 10/3/1964 1811976970 908 MAIN STREET ASBURY PARK NJ 07712 DISQUALIFICATION 7/22/2017 PERMANENTCUTLER, JAZMERE LPN 12/7/1994 131 HUNTLEY AVENUE BAYVILLE NJ 08721 DISQUALIFICATION 8/17/2019CUVIELLO, CHRISTINA LPN 11/20/1978 1647 WHITTIER AVENUE TOMS RIVER NJ 08753 DISQUALIFICATION 4/24/2018CZYZYK, LISA M. RN 2/9/1962 12 VILLAGE COURT, APT. A TRENTON NJ 08690 SUSPENSION 9/13/2013DACONTI, JOHN DO 4/9/1947 1063460939 13 MEDFORD ROAD MORRIS PLAINS NJ 07950 DEBARMENT 6/13/2016DAFTARY, REKHA B. MD 12/18/1953 81B EAST MAIN STREET MENDHAM NJ 07943 DISQUALIFICATION 2/29/2008



28






EXPIRATION DATE

DAHAB, YASIR 5/28/1959 5 PARK STREET ROSELAND NJ 07068 DISQUALIFICATION 12/12/2001DAHHAN, MOHAMED Z. MD 10/28/1967 1417279779 WINDING WAY WEST PATERSON NJ 07424 SUSPENSION 11/20/2008 4/3/2014DAILY, GALE CHHA 7/27/1959 14 SUDBERRY LANE WILLINGBORO NJ 08046 SUSPENSION 7/19/2001DALEY, ROBERTA LPN 2/10/1957 36 HOLLY DRIVE PARLIN NJ 08859 SUSPENSION 8/20/2001D'ALLEGRO, FRANK RPH 3/26/1928 32 SUMMIT AVENUE CEDAR GROVE NJ 07009 DISQUALIFICATION 8/5/1990DALTON, ERIN RN 7/4/1980 14 VICTORIAN WAY WEST DEPTFORD NJ 08090 DEBARMENT 2/20/2013 10/27/2020DALY, JAMES J. EMT 9/23/1969 504 EAST FRANKLIN AVENUE EDGEWATER PARK NJ 08010 DISQUALIFICATION 8/7/2013

DALY, LAUREN MD 3/7/1972 1952492233 SCI CAMBRIDGE SPRINGS, 451 FULLERTON AVENUE

CAMBRIDGE SPRINGS PA 16403 DISQUALIFICATION 11/20/2015

DALY, LAUREN MD 3/7/1972 1952492233 SCI CAMBRIDGE SPRINGS, 451 FULLERTON AVENUE

CAMBRIDGE SPRINGS PA 16403 DISQUALIFICATION 8/5/1990

D'AMICO, DENNIS RPH 4/12/1951 91 OTTOWA ROAD SOUTH MARLBORO NJ 08817 DISQUALIFICATION 3/11/1985DAMMERS, SEAN 2/22/1978 255 SANTIAGO AVENUE RUTHERFORD NJ 07070 DEBARMENT 9/2/2012DANIEL, ALAN L. LCSW 5/13/1945 415 KEIM BOULEVARD BURLINGTON NJ 08016 SUSPENSION 8/20/1999DANIEL, ALAN L. LCSW 5/13/1945 3 HARRISON PARK LANE BURLINGTON NJ 08016 SUSPENSION 3/17/2000DANIEL, ALAN L. LCSW 5/13/1945 202 SPRING GARDEN ROAD ANCORA NJ 08037 DISQUALIFICATION 10/20/2002DANIEL, THERESA D. 6/6/1955 3 HARRISON PARK LANE BURLINGTON NJ 08016 SUSPENSION 3/17/2000DANIEL-CONOVER, NAHLA CHHA 10/3/1995 191 RUTLEDGE AVENUE EAST ORANGE NJ 07017 DEBARMENT 8/1/2017DANIELS, BERLYN E. CHHA 8/2/1965 WHITE HORSE AVENUE TRENTON NJ 08610 DISQUALIFICATION 10/13/2008DANIELS, CLIFTON 12/7/1970 37 HUGHES STREET MAPLEWOOD NJ 07040 DEBARMENT 7/17/2009 7/17/2014D'ANTIGNAC, CHARLOTTE 12/5/1943 3 CHURCHILL DOWNS WEST LONG BRANCH NJ 07764 SUSPENSION 3/10/2000

DARA, PARVEZ MD 4/9/1951 1215952775 214 COMMONS WAY, BLDG B

TOMS RIVER NJ 08755 DEBARMENT 10/12/2011

DARBY, MARK COUNSELOR

8/9/1968 SBI305830E, EJSP RAHWAY NJ 07065 DEBARMENT 1/1/2010

DARBY, MARK COUNSELOR

8/9/1968 SBI305830E, EJSP RAHWAY NJ 07065 DEBARMENT 11/18/2010

D'ASCOLI, BARTHOLOMEW

MD 6/3/1949 PO BOX 1869 MONTAGUE NJ 07827 DEBARMENT 8/18/2000

DASS, SUMAN K. MD 10/13/1930 4 BALDWIN AVENUE JERSEY CITY NJ 07304 DEBARMENT 10/4/2000



29






EXPIRATION DATE

DATCHER, ANTHONY 1/31/1984 SCI DALLAS, FOLLIES ROAD, DRAWER K

DALLAS PA 18612 DISQUALIFICATION 11/20/2015

DATESHIDZE, JANE RPH 4/2/1970 617 STOKES ROAD, SUITE 4 MEDFORD NJ 08055 DEBARMENT 6/28/2017DATILUS, SHELSIE CHHA 3/25/1989 533 NORWOOD STREET, FL. 1 EAST ORANGE NJ 07018 DISQUALIFICATION 8/22/2017 PERMANENT

DAVID, RICHARD 3/3/1961 819 EDGEWOOD AVENUE TRENTON NJ 08618 DEBARMENT 9/17/2009 2/17/2016DAVID, VANESSA LPN 10/27/1980 204 N. 17TH STREET BLOOMFIELD NJ 07003 DISQUALIFICATION 12/17/2018DAVIS, ANTOINETTE 6/21/1968 43 VERNON COURT SICKLERVILLE NJ 08081 DISQUALIFICATION 4/23/2007DAVIS, CHARLES M. COUNSE

LOR9/18/1950 1902045511 381 BALA AVENUE BALA CYNWYD PA 19004 SUSPENSION 3/31/2008

DAVIS, CONITA CHHA 7/4/1972 2 SUTTON DRIVE, APT. O-1 MATAWAN NJ 07747 DISQUALIFICATION 8/7/2017DAVIS, COREY 3/20/1969 25 JAMES STREET LAKEWOOD NJ 08701 DISQUALIFICATION 3/12/2006DAVIS, DEYSHA 12/15/1972 12250 ATLANTIC BOULEVARD

#1701JACKSONVILLE FL 32225 DISQUALIFICATION 11/20/2015

DAVIS, ESTELLE CHHA 8/11/1974 71 HAMILTON STREET EAST ORANGE NJ 07017 DEBARMENT 5/31/2018DAVIS, JAMES DANIEL 1/17/1961 145 JUNIPER STREET BROWNS MILLS NJ 08015 DISQUALIFICATION 10/4/1988DAVIS, JAMES S. 11/12/1963 41 B TROY DRIVE SPRINGFIELD NJ 07081 DISQUALIFICATION 9/4/1986 9/4/1994DAVIS, JEFFREY J. MD 3/26/1948 1548258189 5 E. 63RD STREET NEW YORK NY 10065 DISQUALIFICATION 11/22/2016DAVIS, KARIN B. RN 4/15/1971 141 EAST BENNETT AVENUE WILDWOOD NJ 08260 SUSPENSION 10/20/2002 4/14/2014

DAVIS, LORETTA CHHA 7/26/1973 120 CENTRAL PLACE, 202B ORANGE NJ 07050 DEBARMENT 1/19/2018DAVIS, MARK S. DPM 5/23/1965 5 MONTANA DRIVE COLTS NECK NJ 07722 SUSPENSION 4/9/2004DAVIS, MATILDA/MATHILDA

MD 9/23/1926 230 W. JERSEY STREET ELIZABETH NJ 07202 DISQUALIFICATION 6/13/1985

DAVIS, NICOLE RN 3/23/1978 544 ACKLEY ROAD NEWPORT NJ 08345 DISQUALIFICATION 6/4/2018DAVIS, SHANTA LPN 12/4/1973 114 PLUMTREE LANE WILLINGBORO NJ 08046 DISQUALIFICATION 5/11/2019DAVIS, SHARAE CHHA 7/24/1985 116 LANFORD STREET ASBURY PARK NJ 07712 DISQUALIFICATION 1/31/2017DAVIS-HARVEY, DIANA RN 3/12/1984 10 CAMINO COURT SICKLERVILLE NJ 08081 DEBARMENT 9/15/2017 8/6/2021DAVIT, SAMUEL MD 7/3/1952 100 WINSTON DRIVE #B CLIFSIDE PARK NJ 07010 SUSPENSION 4/20/2003DAWLEY, ASHALEY CHHA 3/12/1996 247 MORSE STREET CAMDEN NJ 08105 DISQUALIFICATION 4/19/2018DAWOUD, MONIR A. MD 12/1/1939 7 COLTSFOOT GLEN SADDLE RIVER NJ 07458 SUSPENSION 11/13/2008DAWOUD, MONIR A. MD 12/1/1939 7 COLTSFOOT GLEN SADDLE RIVER NJ 07458 DISQUALIFICATION 9/4/2007DAWSON, LATIA CHHA 5/27/1989 838 4TH AVENUE NEPTUNE NJ 07753 DISQUALIFICATION 7/14/2017 11/9/2020



30






EXPIRATION DATE

DE LA ROSA ACOSTA, BIENVENIDA

CHHA 6/15/1969 355 OAK STREET, APT. 8 PASSAIC NJ 07055 DISQUALIFICATION 1/31/2017

DEAN, ARLENE CHHA 6/3/1948 34 WEST UNION STREET, APT. A

BURLINGTON NJ 08016 DISQUALIFICATION 7/3/2019

DEAN, RANDY MD 5/7/1956 1083924807 3991 NORTH WEST 99TH AVENUE

CORAL SPRING FL 33065 DISQUALIFICATION 11/20/2015

DEANGELO, KRYSTAL RN 7/23/1989 1314 HANCOCK AVENUE VANDERGRIFT PA 15690 DISQUALIFICATION 11/20/2015DEAQUINO, ANTHONY 3/31/1943 11 STONE RIDGE LANE HO-HO-KUS NJ 07423 DEBARMENT 12/19/2002DEBARO, GERRI RN 7/19/1985 3715 ROYCE COURT HILLSBOROUGH NJ 08844 DISQUALIFICATION 3/12/2019DEBIASI, RICK DC 3/23/1964 1861415655 1 ASHLEY PLACE TOWACO NJ 07082 DEBARMENT 6/30/2016DECASTRO, ANGELA LPN 2/6/1960 894 GOSHEN ROAD CAPE MAY COURT

HOUSENJ 08210 DISQUALIFICATION 8/29/2016

DEEMI, SAMUEL 8/19/1965 665 MARTIN LUTHER KING BOULEVARD


DEFEO, DELORES A. CNA 4/27/1947 RR #6 BOX 280-D PLEASANTVILLE NJ 08232 DISQUALIFICATION 4/26/1996DEGILIO, MICHAEL PSYD 9/21/1968 1356329528 144 DOGWOOD DRIVE JIM THORPE PA 18229 DISQUALIFICATION 11/20/2015DEGUZMAN, DAISY MD 1/28/1943 1699865097 111 MULBERRY STREET NEWARK NJ 07102 DISQUALIFICATION 2/20/2014 9/22/2020DEIXLER, GLENN CHHA 9/14/1957 262 PRIVATEER ROAD MANAHAWKIN NJ 08050 DISQUALIFICATION 4/19/2018DEJESUS, YAZMIN CHHA 7/4/1982 654 OHIO AVENUE EWING NJ 8638 DISQUALIFICATION 7/19/2019DEKU, FAUSTINA CHHA 2/7/1976 10 MARSHALL STREET IRVINGTON NJ 07111 DISQUALIFICATION 2/8/2017DEL PIANO, ANTHONY MD 3/9/1960 1922032770 24 DRINKING BROOK ROAD MONMOUTH

JUNCTIONNJ 08052 DISQUALIFICATION 10/15/2015

DELA GENTE, ROBERT AKA DELAGENTE, ROBERT

MD 4/12/1974 1891886230 12 HUNTERS RUN OAKLAND NJ 07436 DISQUALIFICATION 6/12/2019

DELACRUZ, AMELITA CHHA 3/27/1966 62 LEXINGTON AVENUE JERSEY CITY NJ 07306 DISQUALIFICATION 6/28/2018DELAGENTE, ROBERT AKA DELA GENTE, ROBERT

MD 4/12/1974 1891886230 12 HUNTERS RUN OAKLAND NJ 07436 DISQUALIFICATION 6/12/2019

DELGADO, NICOLE RN 6/21/1990 81 WALNUT STREET OAKLAND NJ 07436 DISQUALIFICATION 1/29/2018DELGADO, YOKATI CHHA 6/28/1976 175 BRIGHTON AVENUE PERTH AMBOY NJ 08861 DISQUALIFICATION 1/31/2017DELIA, MICHELLE 3/5/1989 545 W. HILL ROAD GLEN GARDNER NJ 08826 DISQUALIFICATION 4/7/2010DELLAPENNA, LINDA CNA 11/7/1969 52 VAN NESS DRIVE BRICK NJ 08723 DISQUALIFICATION 11/13/2003



31






EXPIRATION DATE

DELOACH, LORRAINE CHHA 7/24/1964 9 DAVID STREET, APT. 3 SOUTH RIVER NJ 08882 DISQUALIFICATION 1/31/2017DELUANTO, LILIANA CHHA 12/10/1993 1160 SUMMIT LANE MOUNTAINSIDE NJ 07092 DISQUALIFICATION 7/2/2018DELUCA, ANTHONY MD 9/4/1962 1043257744 630 PRINCETON AVENUE BRICK NJ 08724 DISQUALIFICATION 12/16/2015DELUCA, ANTHONY MD 9/4/1962 1043257744 630 PRINCETON AVENUE BRICK NJ 08724 DEBARMENT 2/11/2016DELUCA, WENDY RN 10/4/1957 108 GRANDVIEW ROAD HIGHLAND LAKES NJ 07422 DISQUALIFICATION 3/15/2018DEMARCO, CHARLENE C DO 4/8/1951 PO BOX 898801 OKLAHOMA CITY OK 73189 SUSPENSION 7/20/2008DEMARIA JR., WILLIAM R. 11/1/1959 104 WINDSOR COURT PALM BEACH FL 33480 DEBARMENT 1/5/2001DEMASSI, MICHAEL A. LCSW 3/6/1969 1917 WATERS EDGE DRIVE TOMS RIVER NJ 08753 DISQUALIFICATION 12/20/2013DEMEO, ROBERT MD 5/12/1945 1043220262 522 TYSENS LANE, 2ND FL. STATEN ISLAND NY 10306 DISQUALIFICATION 2/23/2015DEMOSS, KATHLEEN M. DC 7/8/1967 14 N. MAIN STREET FLEMINGTON NJ 08822 SUSPENSION 6/19/2001DENNIS, MOSES LPN 5/19/1981 625 GREENWAY AVENUE DARBY PA 19023 DISQUALIFICATION 6/18/2018DENUCCI, NICHOLAS 7/22/1965 51 BARN OWL HACKETTSTOWN NJ 07840 DISQUALIFICATION 7/24/2002DEORIO, ANA G. RN 10/3/1974 COLUMBIA AVENUE NORTH BERGEN NJ 07047 SUSPENSION 10/18/2007DEROSIER-BEAUBRUN, SABRINA

CHHA 12/11/1982 954 SOUTH BROAD STREET TRENTON NJ 08611 DISQUALIFICATION 6/28/2018

DERRICK, NAOMI AKA BASCUS, NAOMI


DERRICK, NAOMI AKA BASCUS, NAOMI


DESAI, BAKUL MD 12/29/1952 1376654624 15 MOUNTAIN RIDGE DRIVE LIVINGSTON NJ 07039 SUSPENSION 3/8/2010 9/10/2019

DESAI, BAKUL MD 12/29/1952 1376654624 15 MOUNTAIN RIDGE DRIVE LIVINGSTON NJ 07039 DISQUALIFICATION 9/20/2012 9/10/2019

DESAI, NEMISH DDS 6/29/1966 1598908295 348 BOONTON TURNPIKE LINCOLN PARK NJ 07035 DISQUALIFICATION 5/18/2019DESANTIS, ANTHONY C. RPH 2/18/1926 105 FRANKLIN STREET BELLEVILLE NJ 07109 DEBARMENT 2/24/2003DESIMONE, EUGENE MD 10/25/1953 1427098268 FCI FORT DIX, PO BOX 2000 JOINT BASE MDL NJ 08640 DISQUALIFICATION 10/28/2015DESIR, MELISSA CHHA 6/24/1989 20 WILLOW DRIVE, APT. 8 OCEAN NJ 07712 DISQUALIFICATION 4/18/2017DESTASIO, VINCENT MD 8/20/1961 1043215650 1851 HOOPER AVENUE TOMS RIVER NJ 08753 SUSPENSION 4/12/2016 5/13/2016DESTASIO, VINCENT MD 8/20/1961 1043215650 1851 HOOPER AVENUE TOMS RIVER NJ 08753 DEBARMENT 5/13/2016DETROLIO, DANIEL RN 7/13/1981 23 FOXWOOD DRIVE, APT. D MORRIS PLAINS NJ 07950 DISQUALIFICATION 3/27/2018

DEVARIS, HELENA D. DMD 8/8/1955 1679723589 35-08 MORLOT AVENUE 1X FAIR LAWN NJ 07410 SUSPENSION 5/21/2013DEVARSO, ANGELA RN 8/15/1976 FCI DANBURY, RT 37 DANBURY CT 06811 DEBARMENT 5/20/2012DEVERA, MONICA T. 5/4/1945 118 BEACON STREET DUMONT NJ 07628 SUSPENSION 8/20/2002



32






EXPIRATION DATE

DEVLIN, MARYELLEN RN 1/21/1959 809 DEVON ROAD RIVERSIDE NJ 08075 DISQUALIFICATION 6/4/2018 PERMANENTDEZENHALL, MERVIN RPH 11/27/1930 SUNSET ROAD AT SUMMIT

TURNWILLINGBORO NJ 08046 DISQUALIFICATION 6/1/1993

DI SPALTRO, FRANKLIN L. MD 5/28/1940 1740627082 MELROSE LANE GREEN VILLAGE NJ 07935 SUSPENSION 10/18/2007DIAZ, CHRISTINA CHHA 2/13/1987 40 MORRIS STREET, APT. 402 PASSAIC NJ 07055 DISQUALIFICATION 2/22/2019

DIAZ, PEDRO P. 1/18/1930 80 SKYTOP ROAD NEWTON NJ 07860 DISQUALIFICATION 5/20/2011DIAZ-PELLOT, NORMA 10/31/1959 500 BERKELY DRIVE BROWNS MILLS NJ 08015 DISQUALIFICATION 3/24/2000DIAZ-PELLOT, NORMA 10/31/1959 258 UNIVERSITY AVENUE PEMBERTON NJ 08068 DISQUALIFICATION 7/19/2001DICARLO, ANTHONY G. 12/21/1936 35 GALT OCEAN DRIVE FT LAUDERDALE FL 33308 DISQUALIFICATION 6/1/1993DICICCO, RICHARD DC 9/28/1963 1073668265 1 MYERS AVENUE BERLIN NJ 08009 DISQUALIFICATION 6/5/2017DICK, SHONDELL CHHA 4/29/1992 196 22ND STREET IRVINGTON NJ 07111 DISQUALIFICATION 1/29/2018 PERMANENTDICKERSON, DENISE M. RN 6/12/1954 126 HILLCREST AVENUE, 2A BLACKWOOD NJ 08012 DISQUALIFICATION 9/22/2010DICOVSKIY, CLAUDIO MD 6/22/1962 1932282845 1308 ABBOTT BOULEVARD FORT LEE NJ 07024 DISQUALIFICATION 8/7/2017DICOVSKIY, CLAUDIO MD 6/22/1962 1932282845 1308 ABBOTT BOULEVARD FORT LEE NJ 07024 DISQUALIFICATION 2/23/2015DICUBELLIS, MICHELE R. LCSW 4/8/1954 4030 ANDERSON AVENUE, SE ALBUQUERQUE NM 87108 DISQUALIFICATION 6/23/2011 10/22/2014

DIEM, MICHELLE C. CHHA 4/18/1990 821 NEVILLE STREET TOMS RIVER NJ 08753 DEBARMENT 9/23/2014DIETERLE, KAREN M. RN 5/31/1960 51 STURBRIDGE DRIVE SICKLERVILLE NJ 08081 SUSPENSION 8/19/2004DIETRICH, LISA B. AKA LOWELL-SENTURIA, LISA

MD 4/2/1967 DOGWOOD TRAIL RANDOLPH NJ 07869 SUSPENSION 11/20/2008

DIETZ, MICHAEL CHHA 2/1/1989 1602 AQUEDUCT COURT TOMS RIVER NJ 08755 DISQUALIFICATION 2/20/2017DIGIORGIO, DAWN K. 10/16/1967 13 EAST PINE STREET 13D WESTVIEW NJ 08093 SUSPENSION 2/19/2004DIKENGIL, MEHMET #79773-054

DDS 3/15/1948 1255608279 FCI FORT DIX, PO BOX 2000 JOINT BASE MDL NJ 08640 DISQUALIFICATION 10/10/2019

DILLARD, LATICIA 3/5/1977 4208 NORTH DRIVE ATLANTIC CITY NJ 08401 DEBARMENT 8/24/2013DILLIGARD, LATASHA CHHA 10/24/1991 320 W. BRANCH AVENUE,

APT. 47CCAMDEN NJ 08021 DISQUALIFICATION 2/8/2017

DILORENZO, PAUL MD 2/7/1954 1699841056 22 NORTHWOODS ROAD OCEAN NJ 07712 DISQUALIFICATION 4/17/2017DILUIGI, KENNETH RN 11/21/1958 RAVENSWOOD WAY SEWELL NJ 08080 DEBARMENT 12/17/2008DIMEO, ALEXANDER DC 5/22/1954 19355 LASERNA DRIVE FORT MEYERS FL 33967 DISQUALIFICATION 3/3/2017DINKEL, ARTHUR R. LCSW 11/9/1945 2 FREEMAN LANE DENVILLE NJ 07834 DEBARMENT 9/29/2000DINKEL, ARTHUR R. LCSW 11/9/1945 2 FREEMAN LANE DENVILLE NJ 07834 DISQUALIFICATION 4/19/2001DIPAOLO, EDMONDO LPN 7/5/1969 136 DANIELS AVENUE BROWNS MILLS NJ 08015 DISQUALIFICATION 5/9/2020



33






EXPIRATION DATE

DIRENZO, ALFRED M. DO 11/3/1934 167 GROVE STREET LODI NJ 07644 DISQUALIFICATION 2/21/1995DISCENZA, RONALD MD 6/21/1954 1528137882 2578 WOLF HOLLOW ROAD ANDES NY 13731 DISQUALIFICATION 4/17/2017

DITA, INC. 500 ORANGE STREET NEWARK NJ 07104 SUSPENSION 2/18/1998DITURO, JOSEPH MD 3/2/1952 1194871459 376 WOOD RIDGE AVENUE WOOD RIDGE NJ 07075 DEBARMENT 2/15/2016DIXIT, DIVY R. RPH 8/25/1969 1619125135 3022 EDWARD STEC

BOULEVARDEDISON NJ 08837 DISQUALIFICATION 4/30/2015

DIXON, SHANNON 2/11/1984 501 IRVING STREET CLEMENTON NJ 08021 DEBARMENT 3/18/2010 3/18/2013DJAMBA, MONDJA CHHA 4/2/1987 17 PHEASANT ROAD CLEMENTON NJ 08021 DISQUALIFICATION 12/6/2017 PERMANENTDJAVID, ISMAIL F. 4/10/1908 160 EAST 89TH STREET NEW YORK CITY NY 10028 DISQUALIFICATIONDLUZNIEWSKI, MICHELE RN 1/31/1989 137 STEPHAN ROAD BRICK NJ 08724 DISQUALIFICATION 2/7/2019DOBROWOLSKI, DONALD DMD 6/17/1955 1184764664 45 BRICK BOULEVARD S-108 BRICK NJ 08723 DISQUALIFICATION 12/29/1995

DOLINER, PAUL MD 12/3/1927 401 US HIGHWAY 22 NORTH PLAINFIELD NJ 07060 DISQUALIFICATION 9/15/1980DOMINIC JR., ANTHONY J. MD 4/27/1951 216 2ND AVENUE UPPER MANASQUAN NJ 08736 SUSPENSION 1/20/2002

DONALDSON, DENISE RN 1/26/1958 53 3RD AVENUE TOMS RIVER NJ 08757 DISQUALIFICATION 7/9/2003 DECEASEDDONALDSON, DENISE RN 1/26/1958 2650 SPRUCE DRIVE LAKEHURST NJ 08733 DISQUALIFICATION 12/29/1995 DECEASEDDONOFRIO, CHRISTINE RN 8/14/1965 207 TULIP LANE FREEHOLD NJ 07728 DISQUALIFICATION 8/3/2017DONOFRIO, DOUG 8/11/1965 1 SPRING LAKE DRIVE FAR HILLS NJ 07931 DISQUALIFICATION 1/4/2012DOOLEY, CHRISTOPHER J. PHD 9/6/1950 10 DEER RUN FREEHOLD NJ 07728 SUSPENSION 2/9/2009DORBOR, BONGO CHHA 4/1/1977 2341 LIBERTY STREET HAMILTON NJ 08629 DISQUALIFICATION 2/20/2017DORIA, LAWRENCE RPH 4/26/1937 6 BROOK PLAZA JACKSON NJ 08527 DISQUALIFICATION 2/7/1984DORSEY, KIONA CHHA 3/31/1994 670 W. GROVELAND AVENUE SOMERS POINT NJ 08244 DISQUALIFICATION 7/22/2019

DORVIL, FAUBERT RN 3/5/1962 651 S. PALM STREET, #201 LITTLE ROCK AR 72205 DISQUALIFICATION 7/4/2014DOSHI, PRIYAKANT S. MD 3/4/1942 11 WARFIELD STREET MONTCLAIR NJ 08625 DISQUALIFICATION 12/2/1997 DECEASEDDOSSEN, SEBRENA CHHA 9/9/1990 24 PHILLIP E. FRANK WAY CLIFFWOOD NJ 07721 DISQUALIFICATION 1/29/2018DOSSOUS, JONAS CHHA 2/2/1977 1927 BANGS AVENUE NEPTUNE NJ 07753 DISQUALIFICATION 10/17/2017DOTOLI, FRANKLIN MD 7/1/1924 460 FRANKLIN AVENUE NUTLEY NJ 07110 DISQUALIFICATION 6/1/1993 DECEASEDDOTRO, ALYCIA AKA ALEXANDRA, ALYCIA

RN 5/9/1975 6 LOWELL ROAD MANALAPAN NJ 07726 DISQUALIFICATION 11/23/2019

D'OTTAVIO, PAOLA RPH 8/29/1966 504 WILLOW OAK DRIVE MAYS LANDING NJ 08330 SUSPENSION 6/4/2007D'OTTAVIO, PAOLA RPH 8/26/1966 504 WILLOW OAK DRIVE MAYS LANDING NJ 08330 DISQUALIFICATION 9/20/2011



34






EXPIRATION DATE

DOUGHERTY-PRICE, ANITA JO

CHHA 3/31/1954 212 WESTMONT AVENUE WESTMONT NJ 08108 DISQUALIFICATION 5/22/2017

DOWNTOWN DENTAL CENTER

1 WEST BROADWAY PATERSON NJ DISQUALIFICATION 2/20/2001

DOYLE, JUDITH M. RN 11/15/1969 71 WILDFLOWER LANE MORRISTOWN NJ 07960 DEBARMENT 10/20/2004 10/27/2017DRAGERT, ROBERT MD 1/23/1970 1558522821 12 E. SEUDDER COURT PENNINGTON NJ 08534 DEBARMENT 9/26/2018 7/21/2020DRIVAS, GUSTAVE S. MD 6/19/1955 1003867730 FCI LORETTO LORETTO PA 15940 DISQUALIFICATION 5/11/2014DRIZAN, LOULEA CHHA 12/27/1978 43B MANLAY MANOR ELIZABETH NJ 07202 DISQUALIFICATION 3/6/2018DUAH, GLORIA CHHA 7/7/1986 68 MYRTLE AVENUE IRVINGTON NJ 07111 DEBARMENT 2/20/2017DUARTE, LEONARD DC 7/21/1951 1568681542 10 INDEPENDENCE COURT JACKSON NJ 08527 DISQUALIFICATION 8/30/2019DUBNOFF, MICHELLE DC 8/4/1969 1225066210 333 PROVINCIAL DRIVE MORGANVILLE NJ 07751 DISQUALIFICATION 6/20/2018DUBOVY, CARL MD 6/28/1933 11 PIPPINS WAY MORRISTOWN NJ 07960 DISQUALIFICATION 12/1/1998DUCHEINE, YVAN MD 6/16/1963 1578638136 310 CENTRAL AVENUE EAST ORANGE NJ 07018 DEBARMENT 11/1/2017 4/5/2018DUFF, RICHARD W. RN 3/8/1966 1260 SUMMERLEA AVENUE WASHINGTON PA 15301 DISQUALIFICATION 12/29/2015DUFFIELD, CAMI R. RN 8/27/1970 119 GRAF AVENUE LAWRENCEVILLE NJ 08648 SUSPENSION 12/20/2000DUFFY, BARBARA AKA GONZOPH, BARBARA

LPN 3/29/1964 208 WAYNE TERRACE COLLINGSWOOD NJ 08108 SUSPENSION 8/19/2004

DULL, JOHN W. DDS 1/11/1955 399 HOOVER AVENUE BLOOMFIELD NJ 07003 DISQUALIFICATION 12/1/1998 DECEASEDDUMITRU, DAN MD 11/27/1970 1073639530 1657 JFK BOULEVARD, FL 1 JERSEY CITY NJ 07305 DEBARMENT 1/11/2016DUQUE, IRMA CHHA 12/19/1949 314 BROADWAY ELIZABETH NJ 07206 SUSPENSION 5/14/2007DURFEE, JANET RN 1/31/1953 103 WOODLAKE DRIVE MARLTON NJ 08053 SUSPENSION 7/20/2004DURIVAGE, SHARON RN/APN 7/14/1963 1407033442 1655 HUNTERS COURT YARDLEY PA 19067 DISQUALIFICATION 6/4/2018DURNIEN, EDWARD CHHA 12/21/1971 215 CREEK ROAD KEANSBURG NJ 07734 DISQUALIFICATION 1/6/2006DURST, LAWRENCE RPH 1/1/1950 FCI FORT DIX, PO BOX 38 FORT DIX NJ 08640 SUSPENSION 6/19/2001DYEVICH, KEVIN J. 1/16/1962 193 LIVINGSTON AVENUE NEW BRUNSWICK NJ 08901 DISQUALIFICATION 8/21/1996DYOUS, KEISHA LPN 1/8/1972 2 BONNIE COURT LAWRENCEVILLE NJ 08648 DISQUALIFICATION 4/24/2018 8/22/2019DZIENISIEWSKI, DONNA J. RN 11/22/1973 9 IVY LANE MIDDLETOWN NJ 07748 DISQUALIFICATION 6/3/2016DZUIK, CAROL CHHA 2/23/1958 416 CABLE AVENUE BEACHWOOD NJ 08722 DISQUALIFICATION 2/8/2017EASTBURN, NORMAN W. DC 10/21/1965 1013056670 424 MATTHEWS LANE JACKSON NJ 08527 DISQUALIFICATION 11/14/2014EASY DENTAL PC 1093093585 5616 GERMANTOWN

AVENUEPHILADELPHIA PA 19114 DISQUALIFICATION 11/20/2015

EATOUGH, PHILIP DO 1/15/1947 1972681674 5 SYCAMORE LANE RUMSON NJ 07748 DISQUALIFICATION 2/26/2010EDANIEWSKI, EDWARD R. 113 FRONT STREET SECAUCUS NJ 07094 DISQUALIFICATIONEDMILAO, CANUNITA 645 NEWARK AVENUE JERSEY CITY NJ 07305 SUSPENSION 4/9/2004



35






EXPIRATION DATE

EDMONDS, KIANNAH CHHA 8/21/1994 916 4TH AVENUE WALL TOWNSHIP NJ 07719 DEBARMENT 12/6/2017EGANEY, BETH LPN 9/23/1972 46 REA AVENUE MIDLAND PARK NJ 07432 DISQUALIFICATION 10/28/2019EGBERT, JENNIFER CHHA 3/5/1979 PO BOX 1129 FORKED RIVER NJ 08731 DISQUALIFICATION 12/26/2018 1/19/2022EGENBERG, IRIS 12/12/1955 153 AVENUE "B" BAYONNE NJ 07002 DISQUALIFICATIONEGLOFF, MARY ANN RN 7/9/1946 1100 KELLY LANE FARMINGDALE NJ 07727 SUSPENSION 5/19/2005EICHHORN, WARREN DC 3/1/1985 1326412297 447 NEW ROAD SOUTHAMPTON NJ 08088 DISQUALIFICATION 2/28/2019EIDMAN, STEVEN DDS 10/12/1956 73 E. LINCOLN AVENUE ENGLEWOOD NJ 07631 SUSPENSION 1/19/2003EISEMANN, OSHER 10/2/1956 345 OAK STREET LAKEWOOD NJ 08701 SUSPENSION 7/23/2018EJIOFOR, UDOKA RN/APN 3/23/1963 1295096584/1 47 KENMORE AVENUE NEWARK NJ 07106 DEBARMENT 4/26/2018 10/20/2020EKSTEROWICZ, DEBORAH LPN 6/6/1954 283 S. BLACKHORSE PIKE MOUNT EPHRIAM NJ 08059 SUSPENSION 7/18/2002

EL SOURY, AHMED #70613-050

MD 8/11/1972 1497745905 FCI FORT DIX, PO BOX 2000 JOINT BASE MDL NJ 08640 DISQUALIFICATION 4/4/2018

ELAMIR, MAGDY MD 4/17/1953 1710081336 14 HIGH MEADOW ROAD N SADDLE RIVER NJ 07458 DEBARMENT 3/18/2015ELAMIR, MAGDY MD 4/17/1953 1710081336 550 SUMMIT AVENUE JERSEY CITY NJ 07306 DEBARMENT 11/5/2010ELBASHIR, IMAD MAHGOUB

1/1/1961 160 ALABAMA AVENUE PATERSON NJ 07505 SUSPENSION 1/28/2001

ELBASHIR, IMAD MAHGOUB

1/1/1961 PO BOX 7450 TRENTON NJ 08628 SUSPENSION 6/17/2004

ELCHAGEA, ISMAIL 10/21/1951 470 CHAMBERLAIN AVENUE PATERSON NJ 07522 DEBARMENT 7/1/2000

ELHAG, ABUBAKER O. 1/19/1962 10 HILL STREET APT. 9W NEWARK NJ 07102 DEBARMENT 11/23/2007ELIA, HARRY R. DC 5/11/1953 1104034578 136 BROADWAY WESTWOOD NJ 07675 DISQUALIFICATION 12/1/1998ELIA-RAGGIO, LORI LPN 2/21/1961 4001 BURRYPORT WAY MOUNT LAUREL NJ 08054 SUSPENSION 3/18/2004ELLIEN, WILLIAM MD 6/19/1955 1437196375 39 CABBAGE XING SAVANNAH GA 31411 DISQUALIFICATION 11/20/2015ELLIOTT, CLAUDIA CHHA 5/3/1974 345 PARK AVENUE, APT. 4 PATERSON NJ 07504 DEBARMENT 9/26/2017ELLIS, KENT R. MD 12/1/1952 1005 N. WASHINGTON

AVENUEGREEN BROOK NJ 08812 DEBARMENT 6/15/2001

ELLISON, RAEFORD LAC 10/19/1952 8 N. SACRAMENTO AVENUE VENTNOR NJ 08406 SUSPENSION 4/18/2002

EMERSON, BARBARA L. RN 9/6/1972 45 HAWTHORNE STREET BROWNS MILLS NJ 08015 SUSPENSION 5/20/2004EMMERICH, MICHELE 9/14/1965 1306342373 200 ROUND HILL DRIVE FREEHOLD NJ 07728 SUSPENSION 4/29/2019 8/2/2021



36






EXPIRATION DATE

ENEMUO, JOHNNY 10/15/1966 215 JACOBY STREET, 1ST FLOOR

MAPLEWOOD NJ 07040 DISQUALIFICATION 5/1/1999

ENEMUO, KENNETH O. RPH 3/30/1962 236-242 S. ORANGE AVENUE NEWARK NJ 07103 DISQUALIFICATION 3/20/1999 10/26/2017

ENGRISSEI, PATRICIA RN 10/6/1953 700 GROVE STREET HADDONFIELD NJ 08033 SUSPENSION 8/18/2005ENOGWE, FELIX RPH 3/25/1953 51 CLIFTON AVENUE, C-401 NEWARK NJ 07104 DISQUALIFICATION 5/24/1999ENOGWE, FELIX RPH 3/25/1953 25 CLIFTON AVENUE NEWARK NJ 07104 DEBARMENT 2/24/2006ENRICO JR., ANTHONY DPM 8/12/1957 1013095975 57 STONEYRIDGE DRIVE LINCOLN PARK NJ 07035 DISQUALIFICATION 5/2/2017ENRICO JR., ANTHONY DPM 8/12/1957 1013095975 99 SUNCREST AVENUE NORTH HALEDON NJ 07508 DEBARMENT 2/8/2017ENRICO JR., ANTHONY DPM 8/12/1957 1013095975 USP LEWISBURG, PO BOX

1000LEWISBURG PA 17837 DISQUALIFICATION 2/5/2019

ERKOBONI, PATRICIA RN 6/25/1964 1850 W. MCGALLIARD AVENUE

TRENTON NJ 08610 DISQUALIFICATION 5/14/2018

ERNST, DAVID J. DDS 7/7/1955 5 BRUNSWICK WOOD DRIVE EAST BRUNSWICK NJ 08816 DISQUALIFICATION 3/31/1995

ESCALERA, EMILY CHHA 11/5/1993 3716 UNION AVENUE, APT. B PENNSAUKEN NJ 08109 DISQUALIFICATION 7/2/2018

ESPADA, MARGARET CHHA 12/3/1976 310 HAMILTON AVENUE SEASIDE HEIGHTS NJ 08751 DISQUALIFICATION 2/8/2017ESPINDOLA, JUAN MD 2/2/1958 1881703726 467 CLIFTON AVENUE CLIFTON NJ 07011 SUSPENSION 8/29/2016 4/1/2017ESPINDOLA, JUAN MD 2/2/1958 1881703726 32 FOREST STREET MONTCLAIR NJ 07042 DEBARMENT 4/1/2017 ESPINDOLA, JUAN MD 2/2/1958 1881703726 32 FOREST STREET MONTCLAIR NJ 07042 DISQUALIFICATION 3/1/2019 ESPOSITO, VINCENT A. MD 12/19/1957 1225008253 5 BUCKINGHAM DRIVE MADISON NJ 07940 DISQUALIFICATION 7/20/2017ESQUERRE, RENE MD 12/25/1951 1033150172 5 ASHLEY ROAD WEST ORANGE NJ 07052 DEBARMENT 7/18/2018 11/8/2018ESSER, ARISTIDE HENRI PSY 5/11/1930 1447249891 337 N. MAIN STREET STE 2 NEW CITY NY 10956 SUSPENSION 10/20/2013ESTAMBUL, BERNARDO 11/10/1948 605 W. 141ST STREET, APT

51 NEW YORK NY 10031 DEBARMENT 1/31/2008

ESTERMAN, SIDNEY N. DPM 5/20/1932 185 CENTRAL AVENUE, STE. 412

EAST ORANGE NJ 07019 DISQUALIFICATION 8/31/2001

ETIENNE, FERNANDE CHHA 11/18/1963 1205 MORRIS STREET #2L ROSELLE NJ 07203 SUSPENSION 3/20/2006EUSEBIO, EDWIN CHHA 4/3/1993 220 S. 30TH STREET CAMDEN NJ 08105 DISQUALIFICATION 1/31/2017EVANS JR., EUGENE MD 7/26/1958 1033284930 301 EAST LINCOLN AVENUE ROSELLE PARK NJ 07204 DISQUALIFICATION 2/9/2017EVANS, ROLAND A. DC 6/15/1967 263 NORTH 3RD AVENUE MANVILLE NJ 08835 DISQUALIFICATION 9/3/2003EVDOKIMOW, DAVID MD 3/23/1960 1508930678 528 TEMPE WICK ROAD HARDING NJ 07960 DISQUALIFICATION 4/12/2018



37






EXPIRATION DATE

EVRA, JOANEL CHHA 5/6/1986 1551B ASBURY AVENUE ASBURY PARK NJ 07712 DISQUALIFICATION 8/29/2017EWING, DIONNA CHHA 12/4/1987 909 HADDON AVENUE CAMDEN NJ 08103 DEBARMENT 7/2/2018EZELL, PAUL MD 2/28/1956 1235130741 251 SAGAMORE ROAD HAVERTOWN PA 19083 DISQUALIFICATION 11/20/2015EZEONYIM, CHARLES I. RPH 2/24/1961 2153 TYLER STREET UNION NJ 07083 DEBARMENT 1/16/2009 1/6/2012FABULIAN, PETER DO 11/9/1947 1023184835 26 WEST MAIN STREET STRASBURG PA 17579 DISQUALIFICATION 2/20/2013FAENZA, MATTHEW RPH 9/22/1938 64 COVENTRY WAY RINGWOOD NJ 07456 SUSPENSION 1/20/2004FAERMAN, VLADIMIR CHHA 11/20/1947 2506 GATES COURT MORRIS PLAINS NJ 07950 DISQUALIFICATION 6/16/2017FAHE, MIREILLE RN 5/3/1976 269 MAIN STREET, APT. B NEW MILFORD NJ 07646 DISQUALIFICATION 3/3/2017 10/24/2018FAISON, LAUREN 3/19/1973 1804 EAST THAYER STREET PHILADELPHIA PA 19134 DISQUALIFICATION 11/20/2015FAKONDO, VICTOR H. RPH 10/19/1956 180 HANSON AVENUE PISCATAWAY NJ 08854 DISQUALIFICATION 8/18/2011FALLAH, KEBEH CHHA 1/1/1994 365 SCHLEY STREET, APT. A8 NEWARK NJ 07112 DISQUALIFICATION 7/14/2017 6/12/2018

FALLUCCA, KARLA JANE APN/RN 2/5/1985 1053734095 21 STONEHAM DRIVE DELRAN NJ 08075 DEBARMENT 10/20/2020FALOWO, YETUNDE 2/16/1972 301 MAPLE AVENUE, APT.

266NORTH PLAINFIELD NJ 07060 DISQUALIFICATION 1/6/2006

FAMILY ENRICHMENT INSTITUTE

415 KEIM BOULEVARD BURLINGTON NJ 08016 SUSPENSION 8/20/1999

FARL, MUTALIB CHHA 3/15/1979 61 NORTH ARLINGTON AVENUE

EAST ORANGE NJ 07017 DISQUALIFICATION 7/3/2018

FARRIS, JOEL CHHA 10/30/1971 212 UNION AVENUE NEPTUNE NJ 07753 SUSPENSION 9/20/2001FARRO, ANDREW 2/3/1961 87 CASTLE RIDGE DRIVE EAST HANOVER NJ 07936 SUSPENSION 6/12/2008FASANO, JUDITH RN 1/25/1961 1770 YORKTOWNE

BOULEVARDTOMS RIVER NJ 08753 DISQUALIFICATION 6/5/2017

FASWALA, MUNIR H. MD 3/20/1957 506 LAGOON BOULEVARD BRIGANTINE NJ 08203 DEBARMENT 9/15/2008FASWALA, MUNIR H. MD 3/20/1957 506 LAGOON BOULEVARD BRIGANTINE NJ 08203 SUSPENSION 6/26/2005FATATO, VIRGINIA A. DC 7/3/1960 1437432960 8 N. WHITEHORSE PIKE HAMMONTON NJ 08009 SUSPENSION 5/5/2003FAULX, LORI RN 8/4/1966 4444 N 7TH AVENUE, APT.

417PHOENIX AZ 85013 DISQUALIFICATION 11/20/2015

FAUSTINO, ALAN MD 4/18/1967 1669482568 110 WEST CHURCH STREET ABSECON NJ 08201 SUSPENSION 8/29/2016 3/8/2019FAUSTINO, ALAN MD 4/18/1967 1669482568 830 PLYMOUTH PLACE, UNIT

2OCEAN CITY NJ 08226 DISQUALIFICATION 10/3/2019

FAUSTINO, ALAN MD 4/18/1967 1669482568 28 W. GILMAR CIRCLE MARGATE CITY NJ 08402 DISQUALIFICATION 3/8/2019 PERMANENTFEE, CATHERINE ANN RPH 5/9/1965 7353 CLUBHOUSE CIRCLE EGG HARBOR CITY NJ 08215 SUSPENSION 10/19/2006



38






EXPIRATION DATE

FEINBERG, IRA 411 CHELSEA STREET PARAMUS NJ 07652 DISQUALIFICATION 6/1/1993FEINMAN, BRIAN DPM 4/29/1963 418 WALNUT STREET NEWARK NJ 07105 SUSPENSION 12/20/2006FEIT, FREDRIC MD 5/29/1949 1093835308 2 TWIN LAKES DRIVE MANALAPAN NJ 07726 DEBARMENT 7/13/2009FELDMAN, BRUCE J. 12/12/1948 807 NORTHWINDS DRIVE BRYN MAWR PA 19010 SUSPENSION 3/18/2004FELDMON, DORON MD 5/25/1960 1194704627 FCI MCKEAN, PO BOX 8000 BRADFORD PA 16701 DISQUALIFICATION 12/29/2015

FELDNER, EDWARD S. MD 11/13/1955 50 E MAIN STREET LITTLE FALLS NJ 07424 DEBARMENT 11/16/1999 DECEASEDFELIX, JESSICA CHHA 4/7/1986 40 PASSAIC STREET, APT. 4D HACKENSACK NJ 07601 DISQUALIFICATION 8/14/2015

FELLUS, JONATHAN L. MD 6/9/1966 1053309195 57 WOODLAND AVENUE GLEN RIDGE NJ 07028 DISQUALIFICATION 8/20/2015 5/21/2020FELSENBERG, SANFORD 517 SO ORANGE AVENUE NEWARK NJ 07103 DISQUALIFICATION 6/1/1993FERMIN, ESPERANZA CHHA 12/18/1981 229 MADISON AVENUE, APT.

1PATERSON NJ 07524 DISQUALIFICATION 2/8/2017

FERNANDEZ, LUIS DPM 12/7/1965 293 MONROE STREET PASSAIC NJ 07055 SUSPENSION 3/26/1997FERRANDINO, LUIGI MD 5/5/1923 8 EAST RAMAPO AVENUE MAHWAH NJ 07430 DISQUALIFICATION 5/20/2007 DECEASEDFERRARI, FRANCIS M. DPM 3/10/1947 482 KEARNEY AVENUE KEARNY NJ 07032 DISQUALIFICATION 2/16/1995FERRINGO, MICHAEL J. 9/5/1979 616 GLEN COURT TURNERSVILLE NJ 08012 DISQUALIFICATION 6/20/2012FERSTANDIG, RUSSELL A. MD 5/17/1949 1780779702 179 MAPLE AVENUE RIDGEWOOD NJ 07450 DISQUALIFICATION 12/7/1987 1/1/2013FIELDS, CARENE CHHA 9/27/1970 190 HAMILTON AVENUE,

APT. #8PATERSON NJ 07501 DISQUALIFICATION 2/20/2017

FIGUEROA, DESIREE CHHA 10/10/1992 11 COLLETON STREET LAKEWOOD NJ 08701 DISQUALIFICATION 2/20/2017FIGUEROA, JORGE MD 7/15/1958 1770542151 493 21ST AVENUE PATERSON NJ 07513 DEBARMENT 1/23/2018FIGUEROA, JORGE MD 7/15/1958 1770542151 USP-LEWISBURG, PO BOX

1000LEWISBURG PA 17837 DISQUALIFICATION 4/19/2018

FILIPPONE JR., DENNIS R. MD 11/18/1957 147 STANTON ROAD FLEMINGTON NJ 08822 DEBARMENT 11/21/1998FILIPPONE, MARK A.P. MD 2/6/1948 1710063797 15 MORRISSEE AVENUE WALLINGTON NJ 7057 DISQUALIFICATION 11/18/2021 PERMANENTFINDER, RICHARD DC 6/12/1956 810 ABBOTT BOULEVARD FORT LEE NJ 07024 DEBARMENT 5/1/2004FINE, EDWARD MD 10/24/1933 271 MOORE LANE HADDONFIELD NJ 08033 DISQUALIFICATION 9/28/1983FINESMITH, ROSS MD 3/27/1961 PARKVIEW AVENUE BASKING RIDGE NJ 07920 DISQUALIFICATION 8/10/2007FINE-TRANS MEDICAL 2824 KENNEDY BOULEVARD JERSEY CITY NJ 07306 DISQUALIFICATION 6/14/1994FINK, DAVID PSYCH 2/26/1928 139 HIGHLAND AVENUE METUCHEN NJ 08840 SUSPENSION 5/20/2003FINKEL, MARINA 4/30/1963 75 STONEGATE DRIVE STATEN ISLAND NY 10304 DISQUALIFICATION 10/3/2013



39






EXPIRATION DATE

FINKEL, MARINA 4/30/1963 EDNA MAHAN CORRECTIONAL

CLINTON NJ 08809 DISQUALIFICATION 6/15/2014

FINLAY MEDICAL LABORATORY

4912 BERGENLINE AVENUE WEST NEW YORK NJ 07093 DISQUALIFICATION 3/14/1998

FIRESPIRIT, INC. 6612 TERRA DOLCE AVENUE ALBUQUERQUE NM 87114 DISQUALIFICATION 6/23/2011FISCHBERG, JUAN C. MD 10/6/1947 354 RUSSELL AVENUE EDGEWATER NJ 07020 SUSPENSION 6/19/2008FISCHGRUND, JOEL MD 3/3/1953 1427097534 56 CORNELL DRIVE LIVINGSTON NJ 07039 DEBARMENT 8/30/2014FISCHGRUND, JOEL MD 3/3/1953 1427097534 56 CORNELL DRIVE LIVINGSTON NJ 07039 DISQUALIFICATION 3/24/2017FISCHMAN, HAROLD MD 6/3/1903 56 BOWDOIN STREET MAPLEWOOD NJ 07040 DISQUALIFICATION 6/1/1993FISH, MICHAEL DMD 10/19/1977 1500 PINE PARK AVENUE LAKEWOOD NJ 08701 DEBARMENT 4/20/2007 7/17/2013FISHER, CALLETTA PHARM 5/16/1996 115 SENECA BOULEVARD BARNEGAT NJ 08005 DISQUALIFICATION 11/21/2016FISHER, DARRYL 4/12/1968 55 SHELBOURNE STREET BURLINGTON NJ 08016 DISQUALIFICATION 3/6/2006FLEISCHER, MARK H. MD 7/7/1948 PO BOX 600, FCI OTISVILLE OTISVILLE NY 10963 SUSPENSION 4/20/2005

FLEISCHMAN, EDWARD DO 10/3/1928 3804 CHURCH ROAD MOUNT HOLLY NJ 08054 SUSPENSION 8/25/1998FLEMING, KEVIN M. MD 6/30/1954 1508816075 710 STATION AVENUE, 2ND HADDON HEIGHTS NJ 08035 SUSPENSION 11/20/2010FLEURANTIN, MARIE RN 9/3/1958 14 OAK TREE COURT WESTAMPTON NJ 08060 DISQUALIFICATION 10/24/2018FLEURANTIN, RUBEN J. MD 11/20/1951 SCOTLAND ROAD SO. ORANGE NJ 07079 SUSPENSION 3/20/2008FLEURY, DIANE RN 2/22/1951 552 PENNY STREET FRANKLINVILLE NJ 08322 SUSPENSION 5/20/2001FLORES, CARMEN CHHA 10/25/1975 95 PROSPECT STREET, APT. PASSAIC NJ 07055 DISQUALIFICATION 3/6/2018FLORES, MARIE MIRAVITE RN 2/15/1957 258 DEEP BROOK COURT PISCATAWAY NJ 08854 DEBARMENT 9/20/2004FLORES, MELBA CHHA 11/17/1969 106 MAPLE AVENUE BOONTON NJ 07005 DISQUALIFICATION 2/20/2017FLOUNDERS, JOSEPH P. LPN 11/3/1968 106 W. MIAMI AVENUE VILLAS NJ 08251 SUSPENSION 10/20/2005FLOWERS JR., HERMAN J. CHHA 10/30/1964 143 URSINUS COURT PEMBERTON NJ 08075 DISQUALIFICATION 12/10/1997FLOWERS, FELICIA CHHA 7/11/1977 321 NEPTUNE BOULEVARD NEPTUNE NJ 07753 DISQUALIFICATION 7/14/2017FLOWERS, HERMAN T. 143 URSINUS COURT PEMBERTON NJ 08075 SUSPENSION 3/16/1999FLOYD, JAMES 7/11/1963 1733 BLAKE BOTTOM ROAD HUNTSVILLE AL 35806 DISQUALIFICATION 2/26/2010FOGLER, SEAN MD 10/8/1968 1548322068 1900 HAMILTON STREET PHILADELPHIA PA 19130 DISQUALIFICATION 8/28/2017FOGLER, SEAN MD 10/8/1968 1548322068 201 N. 8TH STREET, UNIT 911 PHILADELPHIA PA 17105- DISQUALIFICATION 5/20/2019FOLK, THOMASA A. 2/3/1960 463 IRVINGTON AVENUE ELIZABETH NJ 07201 DISQUALIFICATION 3/19/2006FOLKERTS, ANNAMARIA MD 8/24/1961 32 OAK PLACE HAWTHORNE NJ 07506 DISQUALIFICATION 12/8/1993FONTANELLA, DANIEL DC 10/16/1964 27 MOUNTAINWOOD COURT TOTOWA NJ 07512 SUSPENSION 11/20/2003FONTANEZ, MODESTO MD 1/4/1948 1851395826 1838 2ND AVENUE NEW YORK NY 10128 DISQUALIFICATION 10/7/2011FORBES, AASE RN 4/5/1967 882 DEWEY STREET UNION NJ 07083 DISQUALIFICATION 4/20/2009



40






EXPIRATION DATE

FORD, MARYKATE RN 4/23/1985 103 SWEETWATER DRIVE CINNAMINSON NJ 08077 DISQUALIFICATION 7/30/2018FORD, TAMIKA CHHA 600 ELM STREET CAMDEN NJ 08102 DISQUALIFICATION 1/31/2017FORDE, SHIVONNE 11/24/1982 57 CHESTNUT STREET C4 EAST ORANGE NJ 07018 DISQUALIFICATION 3/8/2010 3/8/2015FORMAN, STEVE DPM 5/10/1957 1700850096 15 CANTERBURY PLACE SICKLERVILLE NJ 08081 DEBARMENT 4/18/2017FORNEY, DONALD 6/20/1967 354 CRESCENT STREET HARRISBURG PA 17104 DISQUALIFICATION 11/20/2015FORSHAY, LAUREN RN 1/12/1977 2201 RIVER ROAD PT. PLEASANT BORO NJ 08742 DISQUALIFICATION 10/25/2016 6/26/2017FORTI, PAUL J. PSYCH 6/24/1949 6 SILVER SPRING COURT EAST HANOVER NJ 07936 DISQUALIFICATION 7/19/2001FORTUNATO, FRANKLIN MD 12/31/1949 1548278930 FMC - DEVENS, PO BOX 879 AYER MA 01432 DISQUALIFICATION 2/11/2016FORTUNATO, FRANKLIN MD 12/31/1949 1548278930 127 PINE STREET MONTCLAIR NJ 07042 DISQUALIFICATION 6/29/2015FOSTER, DEBRA CHHA 1/11/1995 714 ZLOTKIN CIRCLE, APT. 6 FREEHOLD NJ 07728 DISQUALIFICATION 4/18/2017FOWLER, BERNARD J. MD 3/24/1945 1326105032 15 GRIST MILL RUN MAHWAH NJ 07430 DISQUALIFICATION 3/27/2014FOWLER, BERNARD J. MD 3/24/1945 1326105032 1341 MIDDLE GULF DRIVE SANIBEL FL 33957 DISQUALIFICATION 8/20/2015FOX, SUSAN DMD 12/28/1979 1952661472 2300 WALNUT STREET PHILADELPHIA PA 19103 DISQUALIFICATION 12/29/2015FRAENKEL, DAVID M. DDS 12/7/1957 1790774271 BERGEN MALL DENTAL

OFFICEPARAMUS NJ 07652 DISQUALIFICATION 11/4/1991 4/5/2018

FRANCILLON. CARLINE LPN 7/23/1985 98 ASHLAND AVENUE, 2ND WEST ORANGE NJ 07052 DEBARMENT 11/13/2017FRANCO, DAISY CHHA 9/5/1973 URB JARDIN DE S. ANNA COAMO PR 00769 DISQUALIFICATION 8/10/2007FRANCOIS, EMMANUEL MD 5/4/1954 1457383382 187 HOBART GAP ROAD LIVINGSTON NJ 07039 DISQUALIFICATION 10/10/2016 7/19/2019FRANCOIS, ESTHER CHHA 9/21/1986 514 LIDGERWOOD AVENUE ELIZABETH NJ 07202 DISQUALIFICATION 1/17/2018FRANK, OLEG MD 1/22/1971 1457469090 40 FERRY STREET NEWARK NJ 07105 DEBARMENT 9/9/2016 2/7/2020FRANKLIN MEDICAL 14 FRANKLIN STREET BELLEVILLE NJ DISQUALIFICATION 10/15/1999FRARE, ROBERT DMD 9/16/1964 1740477553 15 PROMENADE PLACE VOORHEES NJ 08043 DISQUALIFICATION 8/29/2014FRASCA, CLIFFORD C. 5/22/1961 637 WESTON DRIVE TOMS RIVER NJ 08755 SUSPENSION 4/8/1999FRASER, KEITH MD 7/25/1957 1881621266 6 WEDGEWOOD DRIVE, UNIT VERONA NJ 07044 DISQUALIFICATION 1/10/2011 12/4/2014FRASER, SHAWN E. 1/1/1969 PO BOX 7000 FORT DIX NJ 08640 SUSPENSION 10/20/2005FREDERICK, KIMBERLY M. RN 8/21/1966 78 BOUNDARY AVENUE HANOVER PA 17331 DEBARMENT 9/12/2008FREE, KEVIN R. MD 12/13/1955 14 PATTEN TERRACE CEDAR GROVE NJ 07009 DISQUALIFICATION 7/14/1998 DECEASEDFREILER, JOHN DMD 8/14/1938 1295815710 2307 WARRENS WAY WANAQUE NJ 07465 DISQUALIFICATION 12/26/2018FREMPONG, EBENEZER CHHA 8/12/1969 30 POST STREET, APT. 6M YONKERS NY 10705 DEBARMENT 7/2/2018FRENCH, EUGENE MD 10/22/1959 1215927843 241 SUMMIT AVENUE HACKENSACK NJ 07601 DEBARMENT 4/18/2016FRICK, JAEMS 10/17/1959 1626 ABBOT AVENUE TOMS RIVER NJ 08753 DISQUALIFICATION 5/5/2004FRIDMAN, LEV CHHA 7/12/1941 6 SALT MEADOW ROAD EAST BRUNSWICK NJ 08816 DEBARMENT 5/2/2017FRIED, MARTIN MD 1/23/1958 1407087802 5 SHINNECOCK HILLS DRIVE ASBURY PARK NJ 07712 DEBARMENT 10/21/2019



41






EXPIRATION DATE

FRIED, MARTIN MD 1/23/1958 1407087802 5 SHINNECOCK HILLS DRIVE ASBURY PARK NJ 07712 DISQUALIFICATION 9/17/2018

FRIEDMAN, AMIR MD 6/30/1968 1417907361 390 N. BROADWAY, STE 1000 PENNSVILLE NJ 08070 DEBARMENT 8/1/2014 8/11/2016FRIEDMAN, LAWRENCE A. 10/1/1947 1688-90 54TH STREET BROOKLYN NY 11024 DISQUALIFICATION 6/16/2002FRIEDMAN, SHERRY RN 1/11/1968 12 HOPI TRAIL OAK RIDGE NJ 07348 SUSPENSION 9/19/2003FRIEND, CHARLES LPN 6/18/1955 2336 CORBETT ROAD PENNSAUKEN NJ 08109 SUSPENSION 6/19/2003FRIMPONG, JOSEPH CHHA 3/2/1948 357-363 LINCOLN AVENUE, ORANGE NJ 07050 DISQUALIFICATION 1/31/2017FRIMPONG, KOFI LPN/RN 7/23/1951 ESSEX ROAD MAPLEWOOD NJ 07040 DEBARMENT 12/20/2007FRISCH, FREDERICK MD 5/10/1917 7 SOUTH DUDLEY AVENUE VENTNOR NJ 08406 DISQUALIFICATION 3/5/1994 DECEASEDFRITTS, LARRY F. RN 5/15/1965 5 AUTUMN RIDGE LANE PHILLIPSBURG NJ 08865 SUSPENSION 6/20/2005FRITZ, GINA LPN 2/24/1963 52718-2 PIMA COURT KILEEN TX 76543 DISQUALIFICATION 5/14/2018FROHWIRTH, DANIEL H. MD 6/6/1947 MEADOW ROAD, PO BOX

274WHITEHOUSE NJ 08888 DISQUALIFICATION 4/18/1992

FROMER, CARL H. MD 4/25/1950 1000 CLOVER ROAD, APT. 7R STATEN ISLAND NY 10314 DISQUALIFICATION 6/20/2000

FROMM, JOSEPH MICHAEL

10/29/1947 28301 ATLANTIC AVENUE #110 S

ATLANTIC CITY NJ 08401 DISQUALIFICATION 3/17/1991

FROSCH, LISA AKA LISA PLOTTS

RN 4/15/1976 111 BEECHWOOD AVENUE OAKLYN NJ 08107 SUSPENSION 10/18/2001

FRYE, ROBIN CHHA 7/19/1963 1224 WASHINGTON AVENUE CAMDEN NJ 08104 DISQUALIFICATION 2/13/2018 PERMANENTFRYER, CYNTHIA LPN 12/8/1967 PO BOX 121 MERRY HILL NC 27957 DISQUALIFICATION 12/29/2017FUNICELLO, KELLY M. AKA MCLAUGHLIN, KELLY

LPN 12/27/1971 SANDYBROOK ROAD MANALAPAN NJ 07726 SUSPENSION 8/20/2008

FURLONG, KELLY AKA PHARM 3/21/1985 52 CORNELL DRIVE HAZLET NJ 07730 DISQUALIFICATION 9/23/2016GABER, ROBERT A. DDS 11/13/1947 100 VAIL ROAD PARSIPPANY NJ 07054 DISQUALIFICATION 12/19/1988GABRIEL, NWALA RPH 7/7/1960 34 SCHOOL STREET PISCATAWAY NJ 08854 DISQUALIFICATION 2/23/2010GADHOK, RAJINDER S. 8/9/1937 120 CIRCEL AVENUE, BOX BERKELEY HEIGHTS NJ 07922 DISQUALIFICATION 8/12/1997GAFFNEY, JOHN DO 4/7/1962 1710985387 9501 VENTNOR AVENUE MARGATE CITY NJ 08402 DISQUALIFICATION 7/24/2017GAINER, JAHNIA PHARM

TECH11/29/1992 176 AVON AVENUE. APT. 4A NEWARK NJ 07108 DEBARMENT 4/26/2016

GAINES, TONI 8/3/1974 4650 COLES MILL ROAD R-3 WILLIAMSTOWN NJ 08094 DISQUALIFICATION 8/4/2012 8/3/2014



42






EXPIRATION DATE

GAITHER, HERBERT MD 11/21/1936 1453 HILLCREST COURT, APT. CAMP HILL PA 17011 DISQUALIFICATION 11/20/2015GALCIK, DIANE LPN 8/9/1955 34 MAHAN STREET TENAFLY NJ 07670 SUSPENSION 8/20/2001GALIN, MILES A. MD 1/6/1932 EAST END AVENUE NEW YORK NY 10128 DEBARMENT 9/19/2008GALINSKY, KIMBERLY RPH 5/23/1989 220 VAN FLEET AVENUE SOUTH PLAINFIELD NJ 07080 DISQUALIFICATION 8/10/2017GALINSKY, RONALD C. PSYCH 8/13/1941 34 DUNHILL DRIVE VOORHEES NJ 08043 DISQUALIFICATION 12/1/1998GALL, WILLIAM J. DO 4/4/1943 22 STONEGATE COURT BLACKWOOD NJ 08012 DISQUALIFICATION 7/20/2009GALLAGHER JR., WALTER RN 9/19/1950 132 TULIP LANE SUMMIT NJ 07901 SUSPENSION 9/20/2005GALLAGHER, BRENDA JO RN/LPN 5/4/1955 14B WISHING WELL ROAD HAMBURG NJ 07419 SUSPENSION 4/19/2001GALLAGHER, JOANNE M. DC 9/23/1959 108 BENJAMIN AVENUE CONYNGHAM PA 18219 SUSPENSION 10/20/2005GALLAGHER, PATRICIA A. RN 4/3/1986 111 QUAKER ROAD MICKLETON NJ 08056 DISQUALIFICATION 8/20/2014GALLE, JAMES RPH 5/8/1946 105 ELM AVENUE HACKENSACK NJ 07644 DISQUALIFICATION 9/16/2003GALLETTA, ERNEST 3/16/1949 FCI FAIRTON, PO BOX 420 FAIRTON NJ 08320 SUSPENSION 2/19/2009GALLETTA, GEORGE W. 4/13/1952 3001 E. CHESTNUT AVENUE VINELAND NJ 08361 DISQUALIFICATION 2/19/2009GAMAO, EDDIE MD 6/2/1940 1639479397 375 NORTH DRIVE J9 NORTH PLAINFIELD NJ 07060 DISQUALIFICATION 3/14/2018GAMAO, EDDIE MD 6/2/1940 1639479397 375 NORTH DRIVE J9 NORTH PLAINFIELD NJ 07060 DISQUALIFICATION 10/31/2018 PERMANENTGAMUZZA, VINCENT OPTOME

TRIST9/11/1986 1063851285 FCI FORT DIX, PO BOX 2000 JOINT BASE MDL NJ 08640 DISQUALIFICATION 11/20/2018

GANDHI, HIREN 2/15/1962 120 ROLLING BROOK DRIVE EDISON NJ 08820 SUSPENSION 10/20/2005GANETSKY, SVETLANA PT 5/25/1977 1407180037 197 EDWARDS DRIVE SOUTHAMPTON PA 18966 DISQUALIFICATION 11/20/2015GANTI, SHASHI MD 3/15/1954 1023037215 2035 HAMBURG PIKE WAYNE NJ 07410 DISQUALIFICATION 8/20/1997 3/3/2020GARCEN, GINA AKA CIALLELLA, GINA

DC 4/14/1962 57 GREEN STREET WOODBRIDGE NJ 07095 DISQUALIFICATION 3/24/2000

GARCIA, DIANE LCSW 12/3/1947 6612 TERRA DOLCE AVENUE ALBUQUERQUE NM 87114 DISQUALIFICATION 1/18/2012GARCIA, SHEILA CHHA 3/2/1995 1003 W. CHAPLAIN ROAD MANVILLE NJ 08836 DISQUALIFICATION 5/2/2017GARDINER, MICHAEL, A. DC 12/27/1952 1346524907 2066 MILBURN AVENUE MAPLEWOOD NJ 07040 SUSPENSION 2/3/2003GARIPALLI, LAXMIPATHI MD 10/22/1949 1851325500 11 COLTS GAIT LANE COLTS NECK NJ 07722 SUSPENSION 4/21/2008GARIPALLI, LAXMIPATHI MD 10/22/1949 1851325500 11 COLTS GAIT LANE COLTS NECK NJ 07722 DISQUALIFICATION 9/20/2012GARRETSON, MATTHEW PHARM 3/10/1990 119 GLEN AVENUE LAKEWOOD NJ 08701 DISQUALIFICATION 9/23/2016GARRITANO, RALPH E. MD 9/12/1924 281 GROVE STREET ORADELL NJ 07649 DISQUALIFICATION 6/1/1993GAULT, TYMIER CHHA 4/12/1990 180 HAYNES AVENUE BRIDGETON NJ 08302 DEBARMENT 7/22/2017GAYLE, DELORES MD 10/11/1940 1508886664 249 GREGORY AVENUE WEST ORANGE NJ 07052 DEBARMENT 12/16/2015 6/5/2017GAYLE, DELORES MD 10/11/1940 1508886664 249 GREGORY AVENUE WEST ORANGE NJ 07052 DISQUALIFICATION 6/5/2017 PERMANENTGAYLE, LURINE CHHA 2/15/1961 2144 ALDRIN ROAD, #5A OCEAN NJ 07712 DISQUALIFICATION 2/8/2017GECYS, GINTARE T. DO 3/15/1961 1504 BLACKWOOD BLACKWOOD NJ 08012 DEBARMENT 9/22/2015 5/21/2020



43






EXPIRATION DATE

GEFFEN, STEVEN 1/27/1957 50 SKYLARK COURT MARLBORO NJ 07746 DISQUALIFICATION 8/15/2000GENNINGER, LEWIS E. MD 1/26/1916 95 SOUTH MAIN STREET PHILLIPSBURG NJ 08865 DISQUALIFICATION 1/10/1988 DECEASEDGENSHEIMER, MAUREEN LPN 3/1/1957 1409 EDGEMERE ROAD WALL NJ 07719 SUSPENSION 9/19/2002GEORGE, JOBY RPH 5/14/1974 1255481917 395 MYRTLE STREET CLIFFWOOD NJ 07721 DEBARMENT 7/18/2011GEORGIA LUNG ASSOCIATES

1104989136 3820 MEDICAL PARK AVENUE AUSTELL GA 30106 DISQUALIFICATION 11/20/2015

GERARDO, LETRICIA M. MD 6/4/1934 317 MOUNT PROSPECT NEWARK NJ 07104 DISQUALIFICATION 5/30/1997GERMAN, MARIA CHHA 6/17/1967 195 BROADWAY PATERSON NJ 07505 DEBARMENT 5/24/2002GETSON, LEE 6/1/1952 7 HAMILTON COURT SOUTHAMPTON NJ 08088 DISQUALIFICATION 5/12/2016GIACALONE-HEWSON, DC 9/14/1971 1487782504 FCI COLEMAN MEDIUM, PO COLEMAN FL 33521 DISQUALIFICATION 11/20/2015GIALANELLA, CRAIG MD 10/28/1963 1467596502 4 OXFORD ROAD NORTH CALDWELL NJ 07006 DISQUALIFICATION 7/19/2017GIAMPORCARO, STEVEN MD 9/26/1954 1255356994 15 GLEN AIRE DRIVE EGG HARBOR NJ 08234 DISQUALIFICATION 2/22/2019 PERMANENTGIANETTI JR., JOSEPH P. DC 12/21/1956 LINDEMAN AVENUE CLOSTER NJ 07624 SUSPENSION 9/18/2008GIANNOTTO, ANTHONY MD 12/26/1919 31 PALM STREET NEWARK NJ 07106 DISQUALIFICATION 11/24/1988

GIARRETTA, MARY RPH 1/19/1951 9 KINGWOOD AVENUE FRENCHTOWN NJ 08825 DISQUALIFICATION 2/15/2001GIBBONS, SHANIKA CHHA 12/29/1986 11 LINDEN AVENUE EDISON NJ 08817 DISQUALIFICATION 1/31/2017GIBBONS, SHAWN S. 2/7/1972 40 DOVER STREET NEWARK NJ 07106 DEBARMENT 11/24/2007GIBBONS, WAYNE L. MD 12/10/1948 2 EAST RIVER DRIVE WILLINGBORO NJ 08046 DEBARMENT 1/12/2001GIBBS, ARLENE CHHA 1/21/1976 35 CIVIC SQUARE, #23 IRVINGTON NJ 07111 DISQUALIFICATION 1/28/2006GIBBS, ARLENE CHHA 1/21/1976 18 BELLEVILLE COURT, APT C BELLEVILLE NJ 07109 DEBARMENT 5/20/2007GIBBS, MARY ELLEN CHHA 4/22/1971 157 ANDREW STREET HAMILTON NJ 08610 SUSPENSION 2/14/2002GIBNEY, EDWARD 10 CEDAR LAKE DENVILLE NJ 07834 DISQUALIFICATION 6/1/1993GIBSON, MARY E. 1/20/1964 376 MADISON AVENUE RAHWAY NJ 07065 DISQUALIFICATION 7/18/2001GIFFINS-MATLACK, LPN 4/3/1985 46 BURT STREET BRIDGETON NJ 08302 DISQUALIFICATION 8/28/2017GILL, ALYSON R. RN 8/8/1964 115 BRADLEY COURT LAUREL SPRINGS NJ 08021 SUSPENSION 6/19/2003GILL, JEFFREY J. DPM 3/30/1954 1168 BEACON AVENUE MANAHAWKIN NJ 08050 DEBARMENT 9/13/1999GILL, YURI CHHA 12/10/1984 13 PINE GLEN DRIVE SICKLERVILLE NJ 08081 DISQUALIFICATION 9/19/2017GILLARD, MARY RN 8/18/1969 321 SUNSET AVENUE, APT.

2HASBURY PARK NJ 07712 SUSPENSION 4/20/2003

GILLER, LEONID 9/4/1949 4 WOODFERN STREET EDISON NJ 08820 DEBARMENT 8/27/1999GILLIARD, MICHELLE CHHA 4/18/1978 2929 HURLEY POND ROAD WALL NJ 07719 DEBARMENT 1/20/2017GILLISS, ADAM DO 1/31/1966 1982741328 27 EAST CHESTNUT AVENUE MERCHANTVILLE NJ 08109 DEBARMENT 12/16/2015GILMAN, DANIEL 1/14/1953 FCI - FAIRTON, PO BOX 420 FAIRTON NJ 08320 DISQUALIFICATION 7/20/2017



44






EXPIRATION DATE

GILMAN, DENISE DO 2/28/1977 1689986960 108 WOODCREST DRIVE CORAOPOLIS PA 15108 DISQUALIFICATION 11/20/2015 9/19/2016GILMORE, BRUCE MD 10/23/1955 1306985882 FRANKLIN DRIVE ARDMORE OK 73401 SUSPENSION 9/18/2008GILTMAN, JEROME RPH 4/18/1934 7320 VENTOR AVENUE VENTNOR NJ 08406 DISQUALIFICATION 4/30/2007GIRARDY, MATTHEW DDS 3/14/1970 1831278118 1285 BRADFORD RUN SPRING LAKE NJ 07762 DISQUALIFICATION 5/20/2019GITKIN, SAMUEL 9/1/1947 1288 15TH STREET FORT LEE NJ 07024 SUSPENSION 4/18/2002GLASER, VICTORIA M. RN 10/7/1962 1612 THIRD STREET RENSSELAER NY 12144 SUSPENSION 7/18/2002GLASS, JOEL MD 12/23/1942 1861537219 2027 SPRING GARDEN

STREETPHILADELPHIA PA 19130 DISQUALIFICATION 6/28/2017 PERMANENT

GLASS, JOEL MD 12/23/1942 1861537219 2027 SPRING GARDEN PHILADELPHIA PA 19130 DISQUALIFICATION 10/27/2017 PERMANENTGLASS, MICHAEL R. PSYCH 7/3/1933 1345 SLATERVILLE ROAD ITHACA NY 14850 DEBARMENT 1/18/2007GODBOLT, KIMISHA CHHA 1/4/1983 190 HAMILTON AVENUE PATERSON NJ 07501 DEBARMENT 8/24/2017GODWIN, LASTAISA PHARM

TECH6/15/1993 6 HILLSIDE TERRACE SUSSEX NJ 07461 DISQUALIFICATION 2/1/2018

GOLDBERG, CHARLES S. MD 10/3/1953 1164443958 FCI-OTISVILLE, PO BOX 1000 OTISVILLE NY 10963 DISQUALIFICATION 1/22/2016

GOLDBERG, RICHARD MD 2/6/1950 1629136320 FEDERAL BUREAU PRISONS - BROOKLYN NY 11232 DISQUALIFICATION 2/9/2017GOLDBERG, RICHARD MD 2/6/1950 1629136320 95 DAVIS HILL ROAD WESTPORT CT 06883 DEBARMENT 7/1/2015GOLDIS, MICHAEL MD 12/28/1956 1982603247 36 STOKES ROAD MOUNT LAUREL NJ 08054 DISQUALIFICATION 10/30/2020GOLDSTEIN, JACK DO 3/28/1937 1154355055 695A MAIN STREET LUMBERTON NJ 08048 DEBARMENT 8/28/2014 DECEASEDGOLDSTEIN, JACK DO 3/28/1937 1154355055 695A MAIN STREET LUMBERTON NJ 08048 DISQUALIFICATION 11/20/2015 DECEASEDGOLDSTEIN, JEFFREY DO 12/29/1969 1831158088 90 BARNARD ROAD NEW ROCHELLE NY 10801 DISQUALIFICATION 4/14/2021 PERMANENTGOLDTHWAITE, JENNIFER LPN 3/9/1979 507 KENBURY ROAD BRANCHBURG NJ 08876 DISQUALIFICATION 3/15/2018GOLEJ, IVY RN 11/5/1973 631 MARION ROAD NEPTUNE NJ 07753 DISQUALIFICATION 9/9/2016GOLIN, MARK W. MD 11/20/1941 172 FRANKLIN AVENUE,

SUITE 4RIDGEWOOD NJ 07450 SUSPENSION 3/20/2003

GOMEZ, ALFREDO CHHA 12/23/1965 148 NORTH 10TH STREET, PATERSON NJ 07522 DISQUALIFICATION 4/26/2018GOMOLINSKI, NANCY LCSW 1/1/1953 1700986890 23 FORSHEE CIRCLE MONTVALE NJ 07645 DISQUALIFICATION 5/7/2014GONSHERY, DENISE C. RPH 10/19/1963 900 MCELWEE ROAD MOORESTOWN NJ 08057 SUSPENSION 2/20/2005GONZALEZ, ARELIS CHHA 11/1/1985 28 MADOLE PLACE PENNS GROVE NJ 08069 DISQUALIFICATION 1/31/2017GONZALEZ, FELICIA E. DO 9/11/1958 1598850935 1203 GREEN VIEW WAY TOMS RIVER NJ 08753 DEBARMENT 9/19/2011 6/17/2013GONZALEZ, JORDAN RPH 2/14/1980 1992073167 #66214-050, FCI FAIRTON, FAIRTON NJ 08320 DISQUALIFICATION 2/9/2017GONZALEZ, LEAH CHHA 3/27/1993 5 TWIN RIVERS DRIVE EAST WINDSOR NJ 08520 DEBARMENT 1/16/2017 5/6/2021GONZOPH, BARBARA AKA LPN 3/29/1964 208 WAYNE TERRACE COLLINGSWOOD NJ 08108 SUSPENSION 8/19/2004



45






EXPIRATION DATE

GOOBERMAN, LANCE MD 12/8/1944 1194998682 1 SOUTH CENTRE STREET MERCHANTVILLE NJ 08109 SUSPENSION 2/24/2004 7/23/2012GOODEY, KATHLEEN 7/13/1961 333 WHITTIER AVENUE DUNELLEN NJ 08812 SUSPENSION 5/23/1997GOODIN, RICHARD C. MD 8/13/1943 RIVERVIEW CORRECTIONAL OGDENSBURG NY 13669 SUSPENSION 8/19/2004

GOODNIGHT, JAMES W. MD 12/11/1962 1144313131 535 HIGH MOUNTAIN ROAD NORTH HALEDON NJ 07508 DEBARMENT 1/17/2014 4/11/2017

GOODWIN, BARBARA G. RN 2/23/1959 1201 NORTH CHARLOTTE DICKSON TN 37055 SUSPENSION 12/19/2002GORCEY, STEVEN MD 4/18/1960 1679512941 32 VALLEY FORGE ROAD EATONTOWN NJ 07724 DISQUALIFICATION 6/11/2019 1/7/2021GORDON, BARBARA X-RAY 8/23/1963 133 MORTON AVENUE SOUTH PLAINFIELD NJ 07080 DISQUALIFICATION 4/5/2001GORDON, CRAIG W. MD 9/27/1957 164 RIVEREDGE DRIVE CHATHAM NJ 07928 DISQUALIFICATION 9/4/2007GORDON, CRAIG W. MD 9/27/1957 8 SHERWOOD CIRCLE LINDEN NJ 07036 DISQUALIFICATION 3/18/1993GORDON, HOWARD L. MD 2/15/1926 222 BROADWAY NEWARK NJ 07104 DISQUALIFICATION 6/1/1993GORDON, RAHSHEEDA CHHA 3/3/1979 445 SOUTH 11TH STREET NEWARK NJ 07103 DISQUALIFICATION 2/8/2017GORIGANTI, MAHENDER MD 9/19/1959 1144202805 7187 WOODCHUCK HILL

ROADFAYETTEVILLE NY 13066 DISQUALIFICATION 7/20/2015

GOROVITS, LILIA MD 4/20/1958 1427163427 1157 METTLER ROAD HUNTINGTON VALLEY PA 19006 DISQUALIFICATION 8/7/2017GORUKANTI, SURENDER MD 1/19/1968 1750488292 4324 BEDFORD AVENUE BROOKLYN NY 11229 DISQUALIFICATION 8/20/2018GORUKANTI, SURENDER MD 1/19/1968 1750488292 4324 BEDFORD AVENUE BROOKLYN NY 11229 DISQUALIFICATION 1/31/2019 PERMANENTGOTAY, ALEXANDER LCSW 8/26/1961 SSCF, PO BOX 150 DELMONT NJ 08314 DISQUALIFICATION 2/24/2008GOULBOURNE, MARIANA CHHA 6/19/1964 430 S. 13TH STREET NEWARK NJ 07103 DISQUALIFICATION 3/6/2018

GRANGER, MAI AKA CHHA 9/21/1958 15 PEPPERMINT LANE WILLINGBORO NJ 08046 DISQUALIFICATION 9/29/1999GRANT, NICOLE CHHA 11/28/1984 18 BUCKNELL DRIVE TOMS RIVER NJ 08757 DISQUALIFICATION 1/31/2017GRANVILLE, PEDRO JULIO LAB

TECH.1/30/1962 823 BROADWAY WEST LONG BRANCH NJ 07764 DISQUALIFICATION 8/20/2015

GRASSER, JENNIFER AKA RN 7/6/1963 232 CLUB DRIVE WALL NJ 07719 SUSPENSION 10/20/2002GRAUERHOLZ, JOHN E. MD 12/11/1941 PO BOX 2172 LEESBURG VA 22075 SUSPENSION 9/19/2002GRAY, KEVIN 129 CHANCELLOR AVENUE NEWARK NJ 07112 DISQUALIFICATION 6/1/1993GRAY-KEARLY, ASHLEE CHHA 10/24/1987 10 CORAL DRIVE HOWELL NJ 07731 DISQUALIFICATION 1/31/2017GRAYOVSKI, ELIZABETH CHHA 1/29/1986 206 NORTHFIELD ROAD MILLINGTON NJ 07946 DEBARMENT 7/14/2017GRAYSON, MURRAY A. RPH 6/9/1941 163 HAMPTON GREEN STATEN ISLAND NY 10312 DISQUALIFICATION 6/1/1993GRAZIANO, NATALE MD 3/25/1926 470 BROOKSIDE LANE SOMERVILLE NJ 08876 DISQUALIFICATION 12/1/1998 DECEASEDGREEN, JOHN N. MD 10/5/1953 1114072444 61 MAIN STREET WEST ORANGE NJ 07102 SUSPENSION 2/22/2012 6/21/2012



46






EXPIRATION DATE

GREEN, JOHN N. MD 10/5/1953 1114072444 3 PADDOCK COURT BASKING RIDGE NJ 07920 DEBARMENT 9/25/2014GREEN, JOYCE D. CHHA 8/25/1960 PO BOX 145 WOODBINE NJ 08270 SUSPENSION 8/20/2003GREEN, ROBERT MD 3/30/1921 22 OLD SHORT HILLS ROAD LIVINGSTON NJ 07039 DISQUALIFICATION 9/2/1992 DECEASEDGREENBERG, ANTHONY MD 3/17/1960 1487641239 576 STATE ROUTE 94 COLUMBIA NJ 08732 DISQUALIFICATION 10/29/2016GREENBERG, EDMUND RPH 7/15/1939 270 HIGHLAND ROAD SOUTH ORANGE NJ 07079 DISQUALIFICATION 2/7/2000 DECEASEDGREENBERG, LAUREN LPN 4/12/1985 1376 WEST MAIN STREET MILLVILLE NJ 08332 DISQUALIFICATION 5/25/2019GREENE, LIZA RN 2/5/1974 57 N. RIVER DRIVE PENNSVILLE NJ 08070 SUSPENSION 9/19/2003GREENFARB, IRVING DO 9/24/1929 160 LITTLETON ROAD MORRIS PLAINS NJ 07950 DISQUALIFICATION 12/19/1988 DECEASEDGREENFIELD, RONALD W. 6/11/1955 227 CLUB DRIVE WALL NJ 07719 SUSPENSION 7/19/2001GREENLEAF, JANICE LPN 3/25/1954 110 EAST JUNIPER AVENUE NORTH WILDWOOD NJ 08260 SUSPENSION 6/20/2005GREENSPAN, BERNARD DO 7/11/1937 1245231406 484 LAFAYETTE STREET HAWTHORNE NJ 07506 DISQUALIFICATION 8/4/2017 PERMANENTGREENSPAN, BERNARD DO 7/11/1937 1245231406 150 OVERLOOK AVENUE, 10C HACKENSACK NJ 07601 DISQUALIFICATION 9/29/2017 PERMANENT

GRETZULA, CHAD DMD 8/23/1972 1558422311 616 EAST LANCASTER BERWYN PA 19312 DISQUALIFICATION 11/20/2015GRIETZER, JOY RN 1/4/1964 406 EAST FRANKLIN STREET WEST BERLIN NJ 08091 DEBARMENT 7/22/2017

GRIFFIN, CHARLES RPH 9/15/1985 1669757530 HAZELTON USP, PO BOX 2000

BRUCETON HILL WV 26525 DISQUALIFICATION 11/20/2015

GRIFFIN, REMY CHHA 4/14/1984 490 PARK AVENUE, APT. 3-B PATERSON NJ 07504 DISQUALIFICATION 5/2/2017

GRIFFITHS, MAI AKA CHHA 9/21/1958 15 PEPPERMINT LANE WILLINGBORO NJ 08046 DISQUALIFICATION 9/29/1999GRIMES, BRIDGET 1/31/1957 293 LINCOLN STREET PHILLIPSBURG NJ 08865 DEBARMENT 10/29/2012GRINSHPUN, LEV CHHA 11/26/1956 501-F MORRIS AVENUE ELIZABETH NJ 07208 DEBARMENT 7/22/2017GRISSON, SANDRA 2/20/1966 30 SOUTH CHURCH STREET, WAYNESBORO PA 17268 DISQUALIFICATION 12/29/2015GROSS, KENNETH M. DC 1/28/1971 1740488709 333 PROVINCIAL DRIVE MORGANVILLE NJ 07751 DISQUALIFICATION 6/20/2018GROSSETT II, KENNETH W. RPH 6/22/1945 158 SOUTH DUPONT ROAD CARNEYS POINT NJ 08069 SUSPENSION 3/20/2008GRULLON, KADIA CHHA 1/5/1990 204 ACKERMAN AVENUE CLIFTON NJ 07011 DISQUALIFICATION 4/19/2018GUANMESIA, EUNICE AKA RN 7/4/2969 128 FIELDBROOK DRIVE MAGNOLIA DE 19962 DISQUALIFICATION 10/3/2019GUENSCH, LISA M. RN 11/2/1966 85 MORNING GLORY ROAD WARREN NJ 07059 DISQUALIFICATION 5/20/2009

GUERRERO, RAUL 10/25/1968 110 JEROME AVENUE SOUTH BOUND NJ 08880 SUSPENSION 1/20/2004GUERRERO, THAMARA CHHA 4/11/1972 327 OUTWATER LANE #2 GARFIELD NJ 07026 DISQUALIFICATION 4/6/2018GUERRIERO, LU ANN M. DC 7/14/1956 21 KILMER DRIVE, STE. 2A MORGANVILLE NJ 07751 SUSPENSION 9/24/1997



47






EXPIRATION DATE

GUICE SR., JASON C. 1/30/1944 725 ELIZABETH AVENUE NEWARK NJ 07112 SUSPENSION 9/15/2004GUICE, AZIE 7/9/1944 725 ELIZABETH AVENUE NEWARK NJ 07112 DEBARMENT 9/5/2005GUILBERT, RICARDO LPN 4/30/1948 SOUTHERN STATE CORREC DELMONT NJ 08314 DISQUALIFICATION 11/21/1995GUILIANO, GINA RN 12/16/1977 1 KINDERKAMACK ROAD WOODCLIFF LAKE NJ 07677 SUSPENSION 12/18/2003GULLA, FRANK T. MD 2/13/1939 113 RTE. 46 W. WILLOW WAYNE NJ 07470 DISQUALIFICATION 12/7/1999GUPTA, NAVEEN RPH 4/11/1943 1700 OAK TREE ROAD EDISON NJ 08820 DEBARMENT 3/4/1999GUPTA, RASHMI J. COUNSE

LOR6/22/1972 203 HASSE AVENUE PARAMUS NJ 07652 DEBARMENT 7/30/2012

GUPTA, RASHMI J. COUNSELOR

6/22/1972 10913 CORY LAKE DRIVE TAMPA FL 33647 DEBARMENT 7/3/2013

GUPTA, ROHIT 11/14/1975 BAYSIDE STATE PRISON, PO LEESBURG NJ 08327 DISQUALIFICATION 7/4/2019GURBAN, ELHAN 10/15/1962 14 FAHRNER STREET BERGENFIELD NJ 07621 DISQUALIFICATION 8/16/2016GURBAN, ELHAN 10/15/1962 SOUTHERN STATE CF, 4295

RT. 47DELMONT NJ 08314 DEBARMENT 12/16/2015

GUREVICH, NATALIA MD 11/24/1946 31-23 CRESCENT STREET. APT ASTORIA NY 11106 SUSPENSION 9/20/2005GUSSMAN, MICHAEL DPM 6/7/1959 141 GREENBROOK DRIVE MARLTON NJ 08053 SUSPENSION 6/20/2001GUYTON, KATHLEEN 2/20/1943 228 SANFORD STREET EAST ORANGE NJ 07018 DISQUALIFICATION 8/20/2002GUZZI, NICOLE CHHA 6/30/1975 117 SHERIDAN AVENUE ROSELLE PARK NJ 07204 DISQUALIFICATION 7/2/2018GYAPONG, WILLIAM CHHA 5 LORETTA STREET NEWARK NJ 07112 DISQUALIFICATION 6/29/2019HABIB, IMAD 7/19/1962 1529 39TH STREET, 1ST FL NORTH BERGEN NJ 07047 DISQUALIFICATION 9/30/2011HAIDER, MOHAMMED M. 1/15/1966 195 BROADWAY PATERSON NJ 07505 SUSPENSION 12/7/1999HAINES, KEITH E. MD 5/1/1911 1210 BRACE ROAD CHERRY HILL NJ 08034 DISQUALIFICATION 10/15/1991 DECEASEDHAINES, RAMONA L. RN 1/15/1959 103 MEADOWVIEW CIRCLE MARLTON NJ 08053 SUSPENSION 8/19/2004HAINES, ROBBIE A. RN 4/20/1975 WHITE POND COURT ABSECON NJ 08205 SUSPENSION 10/18/2007HAITMANEK, OTTILLIE M. LPN 9/5/1968 4162 BAYBERRY COURT MONMOUTH NJ 08852 DISQUALIFICATION 3/28/2017HALAS, JOHN 6/23/1945 144 WHITEHALL DRIVE VOORHEES NJ 08043 SUSPENSION 5/20/2002HALL, AFRIKA AKA 8/1/1970 BRIARWOOD DRIVE TOBYHANNA PA 18466 DISQUALIFICATION 10/2/2007 6/28/2018HALL, ANNA M. RN 10/11/1937 44 LAKE TRAIL EAST WAYNE NJ 07470 SUSPENSION 10/18/2001HALL, KIM AKA HALL, 11/18/1965 5 UNAMI LANE SCOTCH PLAINS NJ 07076 DISQUALIFICATION 1/23/2009 PERMANENTHAMAD, ALHIBER K. 4/14/1954 100 RESERVOIR AVENUE JERSEY CITY NJ 07307 DISQUALIFICATION 12/1/1998HAMBERG, IVAN OD 2/11/1934 49 W. CHELTEN AVENUE PHILADEPHIA PA 19144 DISQUALIFICATION 8/27/2001HAMDAN, AIMAN MD 4/16/1967 1336186600 7 OAK HILL DRIVE WAYNE NJ 07470 DISQUALIFICATION 8/20/2018HAMDAN, KRISTINA 5/10/1978 7 OAK HILL DRIVE WAYNE NJ 07470 DISQUALIFICATION 11/16/2017



48






EXPIRATION DATE

HAMDAN, KRISTINA 5/10/1978 ALDERSON FPC, GLEN RAY ALDERSON WV 21910 DISQUALIFICATION 7/4/2019HAMED, AHMED 9/17/1977 592 PALISADE AVENUE TEANECK NJ 07666 DISQUALIFICATION 5/20/2018

HAMENOO, LOVESDALE CHHA 12/10/1977 1 SKYTOP GARDENS, APT. 19 PARLIN NJ 08859 DISQUALIFICATION 7/16/2019HAMM, CARRIE RN 3/16/1975 1134 N. STILES STREET LINDEN NJ 07036 SUSPENSION 9/19/2003 2/23/2013HAMM, CARRIE RN 3/16/1975 1134 N. STILES STREET LINDEN NJ 07036 DEBARMENT 2/23/2010 2/23/2013HAMPTON, GLYNDA 12/11/1960 571 MONTGOMERY STREET JERSEY CITY NJ 07302 DISQUALIFICATION 3/29/2002

HAN, DANIEL 5/20/1988 481 WALKER STREET, APT. 1D FAIRVIEW NJ 07022 DISQUALIFICATION 11/29/2016HANDERHAN, LEROY J. RN 9/19/1958 909 ABINGTON ROAD CHERRY HILL NJ 08034 DISQUALIFICATION 5/20/2007HANDS, EVELYN CHHA 3/20/1956 789 WHEATLAND COURT CAMDEN NJ 08104 DISQUALIFICATION 1/27/2006HANNA, ALEXANDRA LPN 12/20/1977 51 NORTHRUP DRIVE BRICK NJ 08724 DISQUALIFICATION 5/2/2018HANNA, ASHRAF PHARM 3/11/1985 50 WILLETT AVENUE SOUTH RIVER NJ 08882 DISQUALIFICATION 11/21/2016HANNAN, SR., PAUL MD 6/20/1975 1639166572 6619 WALLASTON COURT BROOKLYN NY 11204 DISQUALIFICATION 1/15/2021HANSCOM, CRYSTAL RPH 1/9/1980 1407 BROMLEY ESTATES PINE HILL NJ 08021 DISQUALIFICATION 8/8/2011 9/6/2016HARPER, JENNIFER R. RN 12/15/1971 131 HEMLOCK COURT WOODBURY NJ 08096 SUSPENSION 6/19/2003HARRELL, PAMELA L. RN 4/8/1958 1150 REDROCK CANYON KATY TX 77450 SUSPENSION 8/20/2002HARRIGAN, DAVID C. DC 6/14/1952 1932155736 161 W. WHITE HORSE PIKE ABSECON NJ 08201 DISQUALIFICATION 12/29/1995HARRIS, JOHNNIE 8/20/1983 2 LAKE BOULEVARD EWING NJ 08638 DISQUALIFICATION 4/22/2006HARRIS, PAUL AKA PATEL, MD 3/13/1965 GB-46 PO BOX 26010 BEAUMONT TX 77720 SUSPENSION 11/20/2006HARRISON, RONISHA CHHA 3/22/1995 96 KNIGHTS BRIDGE WAY MAYS LANDING NJ 08330 DISQUALIFICATION 10/9/2018HARRIS-POOLE, IRENE PTA 7/26/1955 708G LUCAS LANE VOORHEES NJ 08043 DEBARMENT 8/20/2003HARVILIK, DOROTHEA RN 1/23/1953 20 EAST ALLENDALE ROAD SADDLE RIVER NJ 07458 DISQUALIFICATION 6/28/2017 PERMANENTHASHIM'S MEDICAL PO BOX 930 NEW YORK NY 10013 DISQUALIFICATION 3/26/1994HASSAN, SALAH A. 9/1/1976 105 TONNELLE AVENUE JERSEY CITY NJ 07305 DISQUALIFICATION 5/31/2001HASSETT, IRENE PHD 12/13/1934 1801894803 950 MORGAN HIGHWAY 226 SOUTH ABINGTON

TOWNSHIPPA 18411 DISQUALIFICATION 11/20/2015

HATCHER-MURPHY, KIMBERLY AKA HURBAN, KIMBERLY

LPN 5/5/1971 966 HERMAN DRIVE DEPTFORD NJ 08051 DEBARMENT 7/18/2018

HEALTH PHARMACY, INC. 3 POND ROAD PARSIPPANY NJ 07054 DISQUALIFICATIONHEGGS, PAMELA B. 10/22/1963 PO BOX 4004 CLINTON NJ 08809 DISQUALIFICATION 10/18/2007



49






EXPIRATION DATE

HELLER, ELLIOT MD 12/24/1957 1770688723 1150 AMBOY AVENUE EDISON NJ 08837 DISQUALIFICATION 4/29/2003 6/25/2014HENNESSEY, LISA AKA PA 4/20/1970 143737727 10 POSTOL ROAD CREAM RIDGE NJ 08514 DISQUALIFICATION 5/20/2021HENRY, SARA RN 4/22/1975 54 CARVER AVENUE LINDENWOLD NJ 08021 DISQUALIFICATION 3/7/2008HERMAN, LAWRENCE S. DC 6/25/1966 1881664761 8908 DANVILLE TERRACE FREDERICK MD 21701 DISQUALIFICATION 12/29/2015HERMAN, THERESA RN 9/30/1948 676 HARBOR ROAD BRICK NJ 08724 SUSPENSION 5/20/2004HERNANDEZ, JENNIFER OFELIA

CHHA 1/1/1980 1410 OAK TREE DRIVE (H) NORTH BRUNSWICK NJ 08902 DISQUALIFICATION 6/25/2013

HERNANDEZ, NORA LEE LPN 9/28/1980 4820 OLD HARRISBURG GETTYBURG PA 17325 DISQUALIFICATION 11/20/2015HERNANDO, GILDA 5/19/1956 669A CHAMBERS STREET TRENTON NJ 08611 DISQUALIFICATION 11/8/2002HERSCHMAN, ZVI J. MD 1/20/1960 1033217492 346 WILSON STREET WEST HEMPSTEAD NY 11552 DISQUALIFICATION 4/20/2013HERSCHMAN, ZVI J. MD 1/20/1960 1033217492 1 OLD SHORT HILLS ROAD LIVINGSTON NJ 07039 DEBARMENT 10/28/2013HERSHAN, DAVID MD 11/13/1956 1740280957 3 OWATONNA STREET HAWORTH NJ 07641 DISQUALIFICATION 5/18/2017HESSEIN, AMGAD A. MD 10/2/1956 1578637260 483 SOUTH ORANGE AVENUE SOUTH ORANGE NJ 07079 SUSPENSION 1/26/2012 5/25/2016

HESSEIN, AMGAD A. MD 10/2/1956 1578637260 483 SOUTH ORANGE AVENUE SOUTH ORANGE NJ 07079 DEBARMENT 5/25/2016

HESSEIN, AMGAD A. MD 10/2/1956 1578637260 BAYSIDE STATE PRISON, PO LEESBURG NJ 08327 DISQUALIFICATION 5/1/2017HEYMACH, GEORGE MD 4/14/1978 1568588317 801 W. 57TH TERRACE KANSAS CITY MO 64113 DISQUALIFICATION 8/27/2001HEYMAN, JACK DO 12/9/1917 124 E MT. PLEASANT

AVENUELIVINGSTON NJ 07039 DISQUALIFICATION 1/7/1983 DECEASED

HHCH HEALTH CARE 1639294812 ALDERSON FEDERAL PRISON CAMP, CLAY GRAY ROAD,

ALDERSON WV 24910 DISQUALIFICATION 5/24/2017

HIBBS, ELIZABETH AKA 9/2/1960 2201 BENJAMIN FRANKLIN PHILADELPHIA PA 19130 DISQUALIFICATION 5/18/2019HICKS, MYASIA CHHA 3/27/1995 38-40 JOHNSON AVENUE NEWARK NJ 07108 DISQUALIFICATION 11/8/2017HIGGINS, GARY W. RN 4/13/1971 548 WAYSIDE ROAD NEPTUNE NJ 07753 SUSPENSION 10/20/2002HIGGINS, MARTIN 3/12/1943 706 BLOOMFIELD AVENUE NUTLEY NJ 07110 SUSPENSION 7/20/2005HIGGINS, RANDALL T. RPH 6/3/1986 17 WAVERLY PLACE MATAWAN NJ 07747 DISQUALIFICATION 3/3/2017HILLEY, KATHLEEN M. 1/6/1973 219 CENTER STREET TUCKERTON NJ 08087 DISQUALIFICATION 10/15/2010HILTON JR., JAMES R. DO 6/15/1961 28 BROCKTON COURT BEACON FALLS CT 06403 DEBARMENT 4/3/2002HIMMELWRIGHT, VICTOR 3/24/1919 44 LONDONDERRY WAY SUMMIT NJ 07901 DISQUALIFICATION 6/1/1993HINSON, ANTHONY RN 11/6/1989 566 RECTOR STREET PHILADELPHIA PA 19128 DISQUALIFICATION 5/21/2020HIRES, STEPHANIE RN 11/18/1972 725 FORD AVENUE LANGHORNE PA 19047 DISQUALIFICATION 2/20/2018HIRSH, HOWARD RPH 6/6/1952 1811204605 163 EINSTEIN WAY EAST WINDSOR NJ 08512 DISQUALIFICATION 10/25/2016HO, SHING MD 7/26/1953 6 JAMOR COURT NESCONSET NY 11767 SUSPENSION 10/19/2000



50






EXPIRATION DATE

HOCHBERG, JOHN MD 4/10/1952 1134280480 288 PLEASANT VALLEY ROAD MORGANVILLE NJ 07751 DISQUALIFICATION 9/14/2016

HOCHBERG, JOHN MD 4/10/1952 1134280480 288 PLEASANT VALLEY ROAD MORGANVILLE NJ 07751 DISQUALIFICATION 4/17/2017HODGKISS, KATHLEEN PSYCH 7/13/1977 1013179233 151 KNOLLCROFT ROAD LYONS NJ 07939 DEBARMENT 7/22/2017HOFFMAN, KATHLEEN LPN 9/15/1971 99 CREEK ROAD BRICK NJ 08724 DISQUALIFICATION 9/13/2018HOFFMAN, MARTIN L. MD 8/22/1948 7 CAREFREE LANE SUFFERN NY 10901 DEBARMENT 3/29/2002HOFFSPIEGEL, PAUL 9/23/1940 56 SULLLIVAN DRIVE WEST ORANGE NJ 07052 SUSPENSION 8/6/1998HOFSTETTER, DAVID 2/25/1930 114 COUNTY ROAD 513 PITTSTOWN NJ 08867 SUSPENSION 6/14/2000HOLCA, LIVIU MD 1/25/1958 1053348417 1137 BEACON AVENUE MANAHAWKIN NJ 08050 SUSPENSION 11/25/2014HOLLEY, AKEYA CHHA 8/19/1987 11 MONTICELLO AVENUE, NEWARK NJ 07106 DISQUALIFICATION 7/13/2018HOLLOWAY, JAZMINE CHHA 2/12/1995 95 CUMMINGS AVENUE IRVINGTON NJ 07111 DISQUALIFICATION 1/23/2018HOLLOWAY, LAKEZIA CHHA 2/16/1982 1306 SUMMERFIELD AVENUE ASBURY PARK NJ 07712 DISQUALIFICATION 7/13/2018HOLLOWAY, QUINCEY LSW 3/21/1975 447 EAST 42ND STREET PATERSON NJ 07504 DISQUALIFICATION 1/17/2019 4/24/2019HOLMES, THERESA CHHA 2/20/1986 1290 N. 27TH STREET CAMDEN NJ 08105 DISQUALIFICATION 2/12/2018 8/20/2018HOMAN, WALTER W. CHHA 11/25/1959 FORECASTLE AVENUE BEACHWOOD NJ 08722 SUSPENSION 8/21/2008HOME CARE SOLUTIONS 216 NORTH AVENUE E, STE. CRANFORD NJ 07016 SUSPENSION 1/24/2014HONG, JOSEPH S. MD 1/1/1964 1346258001 34 FOREST DRIVE WATCHUNG NJ 07069 DISQUALIFICATION 9/29/2016HOPKINS, TONYA CHHA 1/13/1972 433 EAST 18TH STREET, 2ND PATERSON NJ 07524 DISQUALIFICATION 9/20/2019HOPPE, GERALD 3/15/1940 BOX 483A, RD 1 MONROEVILLE NJ 08343 DISQUALIFICATION 6/1/1993HORN, MURRAY 7/3/1919 287 GARFIELD AVENUE HAWORTH NJ 07641 DISQUALIFICATION 8/9/1984HORVATH, CHARLYN RN 7/12/1967 3072 BORDENTOWN PARLIN NJ 08859 DISQUALIFICATION 3/27/2018HORWITZ, KENNETH R. RPH 4/19/1962 8 MOHAWK PLACE RANDOLPH NJ 07869 DEBARMENT 10/31/2003 7/20/2011HOUSTON, PLATINUM CHHA 1/19/1992 15 COURTLAND LANE WILLINGBORO NJ 08046 DISQUALIFICATION 9/19/2017HOUTAN, FARAH PTA 7/23/1957 269 STEELMANVILLE ROAD EGG HARBOR NJ 08234 SUSPENSION 10/27/2009HOUTAN, FARAH PTA 7/23/1957 269 STEELMANVILLE ROAD EGG HARBOR NJ 08234 DEBARMENT 5/1/2012HOWARD, REGINA R. 9/6/1989 104 E. 8TH STREET LAKEWOOD NJ 08701 DISQUALIFICATION 10/30/2013HOWARD, ROBIN A. RN 2/14/1962 196 KING AVENUE TRENTON NJ 08638 DISQUALIFICATION 7/19/2001HOWELL, BRIAN LPN 7/11/1975 106 PARKER AVENUE #2 FORKED RIVER NJ 08731 DISQUALIFICATION 7/27/2017HOWELL, CHRISTOPHER CHHA 5/24/1991 978 JOLSON COURT MANCHESTER NJ 08759 DEBARMENT 10/26/2017HOWELL, CLIFTON MD 10/15/1956 1942247622 15 COLONY DRIVE WEST WEST ORANGE NJ 07052 DISQUALIFICATION 8/19/2011HOWELL, CLIFTON MD 10/15/1956 1942247622 15 COLONY DRIVE WEST WEST ORANGE NJ 07052 DEBARMENT 10/18/2012HRABARCHUK, EUGENE MD 8/29/1920 925 CLIFTON AVENUE CLIFTON NJ 07013 DISQUALIFICATION 12/1/1998HSIA, VINCENT RPH 10/5/1959 1710209291 FCI SCHUYLKILL MINERSVILLE PA 17954 DISQUALIFICATION 5/1/2014HU, HSUN TUAN 2/17/1938 154 HOMESTEAD PLACE BOGOTA NJ 07603 DISQUALIFICATION 5/10/1999



51






EXPIRATION DATE

HUBBARD, PETER RN 3/6/1960 1051 WASHINGTON STREET EASTON PA 18042 DISQUALIFICATION 10/25/2016HUDSON, FITZGERALD MD 5/25/1960 1639367725 PO BOX 1000 MILAN MI 48160 DEBARMENT 6/12/2014HUERTA JR., FRANK 8/27/1973 25 CHAPEL STREET BROOKLYN NY 11201 SUSPENSION 1/10/1997HUNDA, RAFAEL MD 9/3/1920 472 RIVER STREET PATERSON NJ 07524 DISQUALIFICATION 9/21/2001HUNTER, CHRISTOPHER LPN 4/23/1961 430 BARTINE STREET SOMERVILLE NJ 08876 SUSPENSION 6/20/2002HUNTER, FRANK L. 7/5/1964 6 HARTZ DRIVE BRIDGETON NJ 08302 SUSPENSION 2/20/2005HURBAN, KIMBERLY AKA HATCHER-MURPHY, KIMBERLY

LPN 5/5/1971 966 HERMAN DRIVE DEPTFORD NJ 08051 DEBARMENT 7/18/2018

HURLEY, DOUGLAS #65501-050

11/25/1979 FCI FAIRTON, PO BOX 420 FAIRTON NJ 08320 DISQUALIFICATION 5/18/2019

HUSSAIN, IFTIKHAR 6/12/1966 9 VAN COURTLAND AVENUE STATEN ISLAND NY 10301 DISQUALIFICATION 1/29/2003HUSSAIN, ZAHID MD 12/3/1974 1992733232 301 ROUTE 9 NORTH FREEHOLD NJ 07728 SUSPENSION 9/30/2011 7/22/2016HUSSKE, JULIE RN 12/18/1980 1105 CRENDALL WAY WAKE FOREST NC 27587 DISQUALIFICATION 11/10/2019HUSTON JR., JOHN A. CHHA 9/18/1956 8 PRODUCTION WAY AVENEL NJ 07001 SUSPENSION 8/29/1997HYMAN, DEBORAH 7/23/1954 6 HASTINGS LANE FLEMINGTON NJ 08822 SUSPENSION 8/20/2006HYMAN, RONALD M. RPH 2/1/1961 3845 DEMPSEY HUNTINGTON VALLEY PA 19006 SUSPENSION 1/19/2005I & I INVALID COACH 85 CENTRAL AVENUE CLIFTON NJ 07015 SUSPENSION 2/19/2004IBRAHIM, ELHADI 4/3/1964 125 HALF MILE ROAD, BOX MIDDLETOWN NJ 07748 DEBARMENT 1/29/2001IBRAHIM, GASIM 10/25/1963 340 FAIRMOUNT JERSEY CITY NJ 07306 DISQUALIFICATION 12/11/1996IBRAHIM, MOHAMMAD MD 8/14/1966 1265494645 871 MCBRIDE AVENUE WOODLAND PARK NJ 07424 DEBARMENT 1/22/2016IGBERASE, CHARLES AKA RN 4/17/1962 14909 DOWNEY COURT, BOWIE MD 20721 DISQUALIFICATION 5/20/2018IGBINADUWA, NEWTON RPH 6/20/1955 116-35 139TH STREET JAMAICA NY 11436 SUSPENSION 5/19/2005

IGHAMA-AMEGOR, IBILOLA

MD 3/12/1962 1639251804/1659453173

59 MAPLE AVENUE VAUXHALL NJ 07088 DISQUALIFICATION 8/16/2017

IGHAMA-AMEGOR, MD 3/12/1962 1639251804/1 204 KEER AVENUE NEWARK NJ 07112 DISQUALIFICATION 5/18/2019IGNACCOLO, EMANUEL MD 3/9/1932 688 WYCOFF AVENUE MAHWAH NJ 07430 DISQUALIFICATION 6/1/1993 DECEASEDIKEH, CHIDI ETHELBER 11/3/1962 PO BOX 26030 BEAUMONT TX 77720 DISQUALIFICATION 3/9/2008ILEM, PRISCILLA G. MD 6/14/1927 1699860684 782 ALPS ROAD WAYNE NJ 07470 DISQUALIFICATION 10/27/2013ILLINGWORTH, DONNA LPN 8/20/1959 1505 CLAIRE ROAD FORKED RIVER NJ 08731 SUSPENSION 5/19/2005INFINITE CARE, INC. 1073549671 6423 RISING SUN AVENUE PHILADELPHIA PA 19111 DISQUALIFICATION 12/29/2015



52






EXPIRATION DATE

INGALLS, ANDREA CHHA 10/7/1989 36 NORWOOD STREET, 3RD FLOOR


INNES JR., GEORGE MD 1/16/1961 1736 EAST GENESEE STREET FAYETTEVILLE NY 13066 SUSPENSION 7/20/2005INNOCENZI, ANTHONY DPM 12/14/1969 1255336079 7972 AQUADALE DRIVE YOUNGSTOWN OH 44512 DISQUALIFICATION 12/29/2015INSABELLA, HARRY DDS 2/5/1958 591 SOMERSET STREET SOMERSET NJ 08873 DISQUALIFICATION 7/1/1997INTELISANO, RONALD DO 12/28/1961 1235200775 46 BUCKINGHAM DRIVE BERLIN NJ 08009 DISQUALIFICATION 3/3/2017INTELISANO, RONALD DO 12/28/1961 1235200775 1504 BLACKWOOD

CLEMENTON ROADBLACKWOOD NJ 08012 DISQUALIFICATION 12/29/2017

IOSIM, ANATOLY CHHA 9217 FALSTON CIRCLE OLD BRIDGE NJ 08857 DEBARMENT 1/20/2017IQBAL, MOHAMMED S. MD 11/1/1947 1972564078 735 LINWOOD AVENUE RIDGEWOOD NJ 07450 DEBARMENT 9/12/2008IRBY, ARCHER DC 10/15/1970 1801927520 115 GRAND AVENUE ENGLEWOOD NJ 07631 DISQUALIFICATION 10/25/2016IRVING, EDWARD J. 5/14/1969 202 SEYMOUR AVENUE NEWARK NJ 07108 SUSPENSION 4/20/2004ISAACSON, STEVEN RPH 10/7/1944 1959 BIRCHWOOD PARK CHERRY HILL NJ 08034 DISQUALIFICATION 4/6/1995ISMAIL, MOHAMMAD RPH 1/25/1957 4 GRAHAM COURT PARSIPPANY NJ 07054 SUSPENSION 12/18/2003IVASHENKO, ALEXANDER PT 5/10/1957 1134289796 31 GOLDSMITH DRIVE HOLMDEL NJ 07333 SUSPENSION 5/25/1999IYENGAR, DEVARAJAN MD 7/22/1953 1689620700 27 EAST 29TH STREET BAYONNE NJ 07002 SUSPENSION 8/25/2015 1/10/2017J & S PHARMACY 214 SECOND STREET ELIZABETH NJ 07207 DISQUALIFICATION 12/1/1998J & S PHARMACY 214 SECOND STREET ELIZABETH NJ 07207 SUSPENSION 7/11/1997JACKSON, AFRIKA AKA 8/1/1970 BRIARWOOD DRIVE TOBYHANNA PA 18466 DISQUALIFICATION 10/2/2007 6/28/2018JACKSON, AMINATU CHHA 6/4/1996 26 JAMES STREET, C12 LAKEWOOD NJ 08701 DISQUALIFICATION 2/8/2017JACKSON, AVILA TYRELL PODIATR 7/9/1971 1811196488 100 PHILLIPS ROAD, APT 62 SOMERSET NJ 08873 DISQUALIFICATION 7/18/2020 PERMANENTJACKSON, DESHONETTE CHHA 4/18/1992 419 EAST 27TH STREET, 2ND PATERSON NJ 07515 DISQUALIFICATION 4/19/2018JACKSON, GEORGE D. PSYCH 8/20/1928 367 FAIRVIEW AVENUE ORANGE NJ 07050 DISQUALIFICATION 6/30/1997JACKSON, MAKEBA CHHA 1/24/1976 15 MILL STREET EATONTOWN NJ 07724 DISQUALIFICATION 7/14/2017JACKSON, ZEKIA CHHA 3/7/1988 232 JUSTIN WAY WILLIAMSTOWN NJ 08094 DISQUALIFICATION 10/19/2017JACKSON-GILLARD, CHHA 6/16/1990 3 BORDEN AVENUE, APT. 8 ASBURY PARK NJ 07712 DISQUALIFICATION 4/24/2018JACOBS, AMY LPN 9/27/1972 620 MOUNTAIN ROAD BUTLER NJ 07405 DISQUALIFICATION 6/5/2017JACOBSON, CRAIG DC 11/17/1965 1219 LIBERTY AVENUE HILLSIDE NJ 07205 DISQUALIFICATION 3/24/2000 DECEASEDJACOBSON, DEBRA 2/6/1969 661 RT. 9 BAYVILLE NJ 08721 DISQUALIFICATION 1/25/2011 1/25/2013JACOBSON, JAY P. DC 5/23/1943 1508084385 25 DEER PATH HOLMDEL NJ 07733 DISQUALIFICATION 4/12/1996JACQUES, ARNOLD, J. MD 10/15/1949 1124170899 31 BRIDGEWATER COURT JACKSON NJ 08527 DISQUALIFICATION 7/30/2011JACQUEZ, MADELIN CHHA 11/4/1993 2141 SOUTH CLINTON

AVENUEHAMILTON NJ 08610 DISQUALIFICATION 2/12/2018



53






EXPIRATION DATE

JAFARI, MARYAM MD 9/16/1970 1831276880 80 LINDEN STREET, APT. M MILLBURN NJ 07041 DISQUALIFICATION 9/20/2014JAFARI, MARYAM MD 9/16/1970 1831276880 176 BLOOMFIELD AVENUE NEWARK NJ 07104 SUSPENSION 2/22/2012JAFFERY, SYED MD 7/8/1961 1235153685 109 TROTTER ROAD EGG HARBOR NJ 08234 DEBARMENT 2/15/2016JAGTIANI, RAJA MD 5/31/1961 1659320281 11 ONTARIO STREET DUMONT NJ 07628 SUSPENSION 6/6/2016 11/29/2016JAGTIANI, RAJA MD 5/31/1961 1659320281 11 ONTARIO STREET DUMONT NJ 07628 DEBARMENT 9/28/2015 JAGTIANI, RAJA MD 5/31/1961 1659320281 46 MOORSGATE CIRCLE 1 EAST WINDSOR NJ 08520 DISQUALIFICATION 3/5/2019 JAKUBCZAK, ARTHUR F. DC 6/3/1952 1053493718 465 RATHBURN PLACE PERTH AMBOY NJ 08861 SUSPENSION 1/18/2001 10/26/2001JAMES, EDWARD DO 7/27/1926 1598789703 505 GROVE STREET, APT. 21 SEWICKLEY PA 15143 DISQUALIFICATION 11/20/2015

JAMES, GLORIA M. RN 10/3/1942 18 LINDEN COURT JERSEY CITY NJ 07305 SUSPENSION 7/20/2005JAMES, SULENNY CHHA 9/24/1979 293-295 BROAD STREET, 2ND

FLNEWARK NJ 07104 DISQUALIFICATION 2/27/2017

JAMISON, ROBERT W. DO 4/4/1945 79 PARTRIDGE LANE CHERRY HILL NJ 08003 DEBARMENT 9/11/2000JANOF, ROY 502 WASHINGTON STREET HOBOKEN NJ 07030 DISQUALIFICATION 1/9/1983JANVIER-PIERRE, MARY 10/16/1968 6400 BRIDGEPORT LANE LAKE WORTH FL 33463 DEBARMENT 5/20/2012JARMON, ROBERT G. MD 11/17/1943 8 BRIGHTON AVENUE SPRING LAKE NJ 07762 DEBARMENT 5/9/2002JASCALEVICH, MARIO E. MD 8/27/1927 10 PRISCILLA LANE ENGLEWOOD CLIFF NJ 07632 DISQUALIFICATION 6/1/1993 DECEASEDJASINSKI, DARIUS DPM 3/17/1975 1013995182 1225 MCBRIDE AVENUE WOODLAND PARK NJ 07424 DEBARMENT 12/29/2016 9/22/2020JASPER, SARAH CHHA 1/6/1985 187 SIERRA COURT WOODBRIDGE NJ 07095 DISQUALIFICATION 1/31/2017JASPER, THEODORE MD 1/1/1958 1528171972 1010 CLIFTON AVENUE CLIFTON NJ 07013 DEBARMENT 8/12/2015JASPER, THEODORE MD 1/1/1958 1528171972 1010 CLIFTON AVENUE CLIFTON NJ 07013 DEBARMENT 12/16/2015JASZCZULT, JOAN E. DO 6/29/1961 50 NEWARK AVENUE, APT BELLEVILLE NJ 07109 DEBARMENT 2/3/2006JAVID, MOHAMMAD A. 3/21/1953 E. JERSEY STATE PRISON RAHWAY NJ 07065 SUSPENSION 8/20/2000JAVID, MOHAMMED A. 3/21/1953 63 FEDERAL STREET METUCHEN NJ 08840 DISQUALIFICATION 4/11/1996JAYARAM, AJIT MD 12/20/1947 1295773869 215 SOUTH BURLINGTON

ROADBRIDGETON NJ 08302 DISQUALIFICATION 8/20/2013

JAYARAM, AJIT MD 12/20/1947 1295773869 215 SOUTH BURLINGTON BRIDGETON NJ 08302 DISQUALIFICATION 4/4/2014JEAN-BAPTISTE, DEMESVAR A.

MD 1/3/1973 1831227719 775 MOUNTAIN BOULEVARD, STE. 1

WATCHUNG NJ 07069 SUSPENSION 9/19/2011 DECEASED

JECK, CHARLES N. DO 6/3/1959 1 CHICKORY PLACE NEWTOWN PA 18940 SUSPENSION 7/5/2002JEDJU, LINDA RN 3/11/1954 33 NINTH STREET, PO BOX

644FLAGSTOWN NJ 08821 DISQUALIFICATION 11/27/2016 8/31/2018

JEFFERSON, MICHAEL K. DMD 8/12/1954 1811956238 408 PADDOCK COURT SEWELL NJ 08080 DISQUALIFICATION 8/16/2016 5/12/2017



54






EXPIRATION DATE

JEFFRIES, MARC 9/5/1964 2 MILLER LANE WHITEHOUSE NJ 08889 DISQUALIFICATION 3/13/2014JELKS, SAMARRA CHHA 3/9/1982 3309 RIDGEWAY ROAD MANCHESTER NJ 08759 DISQUALIFICATION 3/8/2017JEMINI, DAVID 2/1/1952 PO BOX 280, HWY. 698 FAIRTON NJ 08320 SUSPENSION 7/18/2002JEMINI, JACK 7/15/1950 PO BOX 600 ELGIN FL 32542 SUSPENSION 7/18/2002JIMENEZ, CRISTIAN RN 1/5/1995 61 CHESTNUT STREET, APT.

3CONEONTA NY 13820 DEBARMENT 6/10/2019

JIMENEZ, JOSE COUNSE 6/27/1955 EXTENSION VILLA RITA SAN SEBASTIAN PR 00685 SUSPENSION 12/8/2003 12/8/2011JIMS TRANSPORTATION 49 WESTERN PARKWAY IRVINGTON NJ 07111 SUSPENSION 4/11/2006JOACHIM, LEONARD MD 3/10/1950 1720023005 26 LAKE DRIVE MOUNTAIN LAKES NJ 07046 DISQUALIFICATION 12/5/1997JOACHIM, LEONARD MD 3/10/1950 1720023005 25 HIDEAWAY LANE SPARTA NJ 07871 DISQUALIFICATION 5/15/2017JOACHIM, STEPHANIE CHHA 10/7/1990 15 LINDSLEY PLACE, APT. 1R EAST ORANGE NJ 07018 DISQUALIFICATION 1/31/2017JODELKA, ERIK RPH 8/18/1980 1003103946 391 BEECROFT PLACE OAKHURST NJ 07755 DEBARMENT 8/20/2006 2/23/2011JOHNSON, ALICIA LPN 6/4/1985 20 SKYTOP GARDENS PARLIN NJ 08859 DISQUALIFICATION 9/12/2016JOHNSON, BEVERLY M. CHHA 2/3/1957 909 ARMSTRONG ASBURY PARK NJ 07712 DISQUALIFICATION 7/17/2018JOHNSON, BRENDA C. LPN 9/24/1973 232 OAK STREET WILLIAMSTOWN NJ 08094 SUSPENSION 1/19/2003JOHNSON, DEMETRIA CHHA 9/29/1993 21 ROSA PARK BOULEVARD PATERSON NJ 07524 DISQUALIFICATION 7/31/2017

JOHNSON, DENISE M. RN 11/28/1954 12 SIOUX TRAIL DENVILLE NJ 07834 SUSPENSION 4/20/2005JOHNSON, DUWANA L. CHHA 3/10/1969 213 MARTIN LUTHER KING LAKEWOOD NJ 08701 SUSPENSION 9/14/2005JOHNSON, JULIE ANN CHHA 11/19/1958 1145 MANTUA PIKE MANTUA NJ 08051 SUSPENSION 6/19/2001JOHNSON, KIM E. LPN 10/20/1961 6B JANS WAY BYRAM TOWNSHIP NJ 07821 DISQUALIFICATION 11/16/2017JOHNSON, LARHONDA CHHA 10/15/1984 1704 CENTENNIAL VILLAGE CAMDEN NJ 08105 DISQUALIFICATION 2/8/2017JOHNSON, MICHAEL LPN/RN 5/9/1986 899 DIANE COURT WOODBRIDGE NJ 07095 DISQUALIFICATION 3/28/2017JOHNSON, ROBERT D. 6/5/1945 1608 4TH AVENUE ASBURY PARK NJ 07712 DISQUALIFICATION 1/6/2006JOHNSTON, KELLIE RN 12/26/1970 1697 SYLVAN DRIVE BLUE BELL PA 19422 SUSPENSION 10/19/2006JOHNSTON, MICHAEL MFT 10/4/1960 1780999847 SCI CAMP HILL, PO BOX 200 CAMP HILL PA 17001 DISQUALIFICATION 9/29/2017JONES, ANIECE LPN 8/20/1984 625 DREXEL AVENUE ATLANTIC CITY NJ 08401 DEBARMENT 6/4/2018JONES, CYNTHIA R. RN 4/1/1955 1089 HAWSER AVENUE MANAHAWKIN NJ 08050 SUSPENSION 8/20/2002JONES, DAVID W. LPN 6/27/1952 97 LINCOLN PARK NEWARK NJ 07102 SUSPENSION 3/20/2003JONES, IMAJE CHHA 4/13/1993 287 ABLETT VILLAGE CAMDEN NJ 08105 DISQUALIFICATION 2/8/2017JONES, JASMINE CHHA 2/21/1991 304 ERIAL ROAD SICKLERVILLE NJ 08081 DISQUALIFICATION 2/8/2017JONES, KEVIN PHARM 8/3/1992 734 STERLING STREET PLAINFIELD NJ 07062 DISQUALIFICATION 7/22/2017JONES, MICHELLE N. 11/26/1983 446 PROSPECT STREET-B16 LAKEWOOD NJ 08701 SUSPENSION 9/30/2005 11/25/2019JONES, ROSALIN CHHA 11/30/1970 159 PFEIFFER STREET CAMDEN NJ 08105 DISQUALIFICATION 2/20/2017



55






EXPIRATION DATE

JONES, VANESSA A. CHHA 7/30/1989 156 NORTH 18TH STREET EAST ORANGE NJ 07017 DEBARMENT 7/17/2018JONES-HATTOH, CHATIQUA

CHHA 7/8/1984 3 ROANOKE AVENUE, APT. 2C NEWARK NJ 07108 DISQUALIFICATION 1/23/2018

JONES-PRICE, 10/17/1965 PO BOX 1006 WENDELL NC 27591 DISQUALIFICATION 6/1/2000JONES-PRICE, 10/17/1965 120 S. 20TH STREET IRVINGTON NJ 07111 SUSPENSION 3/16/1998JOO, EUI D. MD 11/15/1939 29 TIP TOP WAY BERKELEY HEIGHTS NJ 07922 DISQUALIFICATION 10/14/1985JORDON, SANDRA LPN 4/26/1966 15 CANIS COURT SEWELL NJ 08080 DISQUALIFICATION 6/5/2017JOSE, DELIA V. 9/30/1955 185 S. EUCLID STREET, SUITE

111PASADENA CA 91101 SUSPENSION 4/22/1997

JOSEPH, ALEX CHHA 11/21/1982 1531 SEWALL AVENUE #2 ASBURY PARK NJ 07712 DISQUALIFICATION 6/26/2018JOSHI, JAYENDRA B. 9/13/1959 95-05 37TH AVENUE, APT. 1- JACKSON HEIGHTS NY 11373 DISQUALIFICATION 6/4/1997JOSHI, KAJALBEN LPN 8/25/1992 476 EBONY TREE AVENUE GALLOWAY NJ 08205 DISQUALIFICATION 3/12/2018JOY, RENEE RN 3/29/1968 34 LUTHER ALLEN LANE BRUSH CREEK TN 38547 DISQUALIFICATION 11/16/2017JOYNER, VALERIE CHHA 7/8/1991 19 SCHIRRA DRIVE WANAQUE NJ 07465 DEBARMENT 6/18/2018JRMICK, INC. 911 MAIN STREET BELMAR NJ 07719 DISQUALIFICATION 1/16/2005JUISTON, PEGGY A. 10/19/1946 17 MYRTLE AVENUE IRVINGTON NJ 07111 DISQUALIFICATION 6/5/2000JUNGER, SYLVAIN S. MD 4/29/1956 1497975551 270 PENNINGTON AVENUE PASSAIC NJ 07055 DISQUALIFICATION 4/20/2011JUPITER, RONALD DDS 9/29/1950 1023125879 119 EYLAND AVENUE SUCCASUNNA NJ 07876 DISQUALIFICATION 5/5/2014JUPITER, RONALD DDS 9/29/1950 1023125879 119 EYLAND AVENUE SUCCASUNNA NJ 07876 DEBARMENT 4/15/2016JURGENSON, THEODORE W.

DPM 6/18/1928 438 BROADWAY LONG BRANCH NJ 07746 DISQUALIFICATION 6/1/1993 DECEASED

JYAMFI, CHARLES RPH 9/24/1953 71 OLD SHORT HILLS ROAD WEST ORANGE NJ 07052 SUSPENSION 3/22/2006KADISHA, INC. 667 MOUNT PROSPECT NEWARK NJ 07104 SUSPENSION 5/14/1998KAHONU, ANNE N. 12/19/1985 315 MILL STREET SOUTH PLAINFIELD NJ 07080 DEBARMENT 1/19/2013KAJI, VIKRAM MD 11/12/1935 1346326634 310 COVE LANE BEACH HAVEN NJ 08008 DISQUALIFICATION 4/10/2019 PERMANENTKALFUS, DENIS H. DPM 12/9/1945 1015 EAST GLEN AVENUE WASHINGTON NJ 07606 SUSPENSION 6/19/2003 DECEASEDKALINOSKI, STEPHEN RPH 8/21/1963 178 KINGFISHER DRIVE MIDDLETOWN NJ 07748 DISQUALIFICATION 9/20/2018KALINOWSKI, KAROL RN 5/11/1984 31 COVINGTON LANE VOORHEES NJ 08043 DISQUALIFICATION 3/28/2017 11/18/2019KALLEN, HERBERT 10/26/1919 274 RIVER ROAD ST JAMES ISLAND NY 11780 DISQUALIFICATION 6/1/1993KAMARA, HELEN H. CHHA 3/9/1964 PO BOX 509 PALMYRA NJ 08065 SUSPENSION 10/20/2002KANE, TINA APN/RN 11/27/1967 1366688079 157 EVERGREEN AVENUE VILLAS NJ 08251 DISQUALIFICATION 11/9/2019KANEVSKY, ZHANNA MD 6/6/1961 1073551065 28 KEPPEL AVENUE #10307 STATEN ISLAND NY 10307 DISQUALIFICATION 2/4/2014 PERMANENT

KANG, BYUNG MD 1/1/1940 1164599213 122 LONG HILL ROAD LITTLE FALLS NJ 07424 DISQUALIFICATION 9/23/2016



56






EXPIRATION DATE

KANIA, RAMESHCHAN MD 12/14/1952 1235158403 310 CENTRAL AVENUE, SUITE EAST ORANGE NJ 07018 DISQUALIFICATION 1/20/2014 10/3/2019KANIA, RAMESHCHAN MD 12/14/1952 1235158403 310 CENTRAL AVENUE, SUITE EAST ORANGE NJ 07018 SUSPENSION 2/22/2012 10/3/2019KANKAM, MARTIN 13 G READING ROAD EDISON NJ 07083 DEBARMENT 7/30/2005KANZ JR., JOHN T. RPH 12/21/1947 136 HILLCREST AVENUE HILLTOP NJ 07542 DISQUALIFICATION 9/17/1984KAPLAN, DONALD DPM 12/4/1948 1952433567 701 PALMER AVENUE ALLENHURST NJ 07711 SUSPENSION 3/25/2010KAPLAN, HARMON B. DDS 7/28/1949 1093991044 1251 PATERSON PLANK SECAUCUS NJ 07094 DISQUALIFICATION 8/26/1988KARASEK, ROBERT D. DMD 4/11/1963 1689794042 559 PLAINFIELD AVENUE BERKELEY HEIGHTS NJ 07922 DISQUALIFICATION 11/20/2014KARASEK, ROBERT D. DMD 4/11/1963 1689794042 64 DOCKSIDE DRIVE SOMERS POINT NJ 08244 DISQUALIFICATION 9/19/2016KARES, FRANCIS R. RPH 2/8/1950 615 SUMMIT ROAD UNION NJ 07083 DISQUALIFICATION 2/16/1983 2/16/1991KARFUNKEL, DAVID M. 10/12/1970 100 HOWARD AVENUE PASSAIC NJ 07055 DISQUALIFICATION 4/2/2008 10/25/2013KARGE, FREDRICK PO BOX 190 AVENEL NJ 07001 SUSPENSION 1/28/2007KARNER, ANNA EMT 11/2/1982 17 MAPLE AVENUE PINE BROOK NJ 07058 DISQUALIFICATION 7/23/2002KARSHENBOYM, 8/7/1961 90 WEST HILL ROAD WOODCLIFF LAKE NJ 07677 DEBARMENT 9/20/2007KAUFMAN, SHOSHANA AKA STOCKELBERG, SHOSHANA

LCSW 11/10/1977 349 JESTER COURT OLD BRIDGE NJ 08857 DISQUALIFICATION 7/15/2009 11/7/2014

KAVROS, STEVEN J. DPM 7/22/1954 1316912801 12 HERITAGE COURT CHERRY HILL NJ 08034 DISQUALIFICATION 6/1/1993 8/22/2019KAWAM JABAKJI, MD 1/27/1959 1760541312 6 BARKER PLACE WAYNE NJ 07470 DEBARMENT 5/16/2016KAWAM JABAKJI, MD 1/27/1959 1760541312 6 BARKER PLACE WAYNE NJ 07470 DISQUALIFICATION 7/20/2017KAY, KWAME CHHA 7/1/1985 PO BOX 961186 MIAMI FL 33296 DISQUALIFICATION 2/8/2017KEE, TERRAYA C. CHHA 7/25/1985 CLINTON STREET CAMDEN NJ 08105 DISQUALIFICATION 11/30/2007KEELEN, SUSAN RN 6/7/1965 272 OLD YORK ROAD FLEMINGTON NJ 08822 SUSPENSION 6/20/2001 1/27/2012KEENEY, RICHARD DC 6/29/1946 1255461430 112 BALTIMORE STREET HANOVER PA 17331 DISQUALIFICATION 12/29/2015KELLEY, JANINE RN 4/19/1981 126 S. LECATO AVENUE AUDOBON NJ 08106 DISQUALIFICATION 2/2/2018 PERMANENTKELLOGG, WILLIAM T. MD 4/29/1946 47 MAPLE STREET, STE. 204 SUMMIT NJ 07901 DISQUALIFICATION 1/9/1996 2/28/2014KELLUM, BETZAIDA CHHA 10/20/1987 1936 S. 8TH STREET, APT. CAMDEN NJ 08104 DISQUALIFICATION 2/8/2017KELLUM, EARLENE CHHA 5/25/1978 279 S. BLACKHORSE PIKE MOUNT EPHRAIM NJ 08059 DISQUALIFICATION 3/5/2018KELLY, MICHELLE S. CNA 11/22/1961 963 PARK AVENUE PLAINFIELD NJ 07060 DEBARMENT 3/24/2002KELLY-UPPER, DENISE 7/21/1955 2200 ATLANTIS AVENUE MAYS LANDING NJ 08330 DISQUALIFICATION 12/1/1998KEMENY, GEORGE MD 5/11/1951 39 THIRD STREET ELIZABETH NJ 07206 DISQUALIFICATION 11/22/1977KEMOKAI, JOSEPHINE LPN 12/27/1955 29 BENNETT AVENUE RANDOLPH NJ 07869 DISQUALIFICATION 11/21/2016KENDRICK, SOPHIA CHHA 7/14/1991 4 OAK WALK CAMDEN NJ 08104 DISQUALIFICATION 7/17/2018KENNEALLY, RN 7/26/1990 1308 NOREEN DRIVE BURLINGTON NJ 08016 DISQUALIFICATION 9/30/2019KEREKES, KEVIN #65504- 12/5/1965 FCI SCHUYKILL, PO BOX 759 MINERSVILLE PA 17954 DISQUALIFICATION 3/1/2019



57






EXPIRATION DATE

KESHISHIAN, PAUL DO 6/25/1951 1437207610 625 COBH ROAD RIVER VALE NJ 07675 DEBARMENT 4/22/1999 3/15/2000KEYES, DONNA CHHA 6/25/1976 4433 EAST MILLS ROAD MAPLE SHADE NJ 08052 DISQUALIFICATION 2/20/2017KHAIR, IMADELIN A. 12/30/1959 160 ALABAMA AVENUE PATERSON NJ 07505 SUSPENSION 1/28/2001KHAIR, IMADELIN A. 12/30/1959 FCI FORT DIX, PO BOX 2000 JOINT BASE MDL NJ 08640 DISQUALIFICATION 5/24/2017KHAJAVI, ABDOLALI MD 1/1/1931 HIGHWAY 94 & OSBOW LANE FRANKLIN NJ 07416 DEBARMENT 8/20/1999

KHAN, ASIF ALI 8/31/1961 909A BROAD STREET NEWARK NJ 07102 SUSPENSION 6/5/1996KHAN, AZAM HAYAT 1/18/1962 687 FRELINGHUYSEN NEWARK NJ 07114 SUSPENSION 12/16/1998KHAN, AZAM HAYAT 1/18/1962 687 FRELINGHUYSEN NEWARK NJ 07114 DISQUALIFICATION 10/21/1999KHAN, AZAM HAYAT 1/18/1962 107 CHARLESTON AVENUE STATEN ISLAND NY 10309 DISQUALIFICATION 7/7/2008KHAN, MUNIR 8/15/1953 238 GRAND STREET, APT. 1 JERSEY CITY NJ 07302 DEBARMENT 8/20/2009KHAN, SALEEM M. 9/19/1967 336 2ND STREET, APT. 1 JERSEY CITY NJ 07302 SUSPENSION 7/20/2003KHAN, TAUQIR 8/17/1958 PO BOX 420 FAIRTON NJ 08320 SUSPENSION 8/19/2010KHANDWALA, NITIN RPH 8/24/1951 225 MILLBURN AVENUE MILLBURN NJ 07041 DISQUALIFICATION 10/21/1999 11/29/2012KHANNA, YASH K. MD 12/28/1941 1093805012 825 BLOOMFIELD AVENUE,

STE. L1VERONA NJ 07044 SUSPENSION 2/22/2012

KHANNA, YASH K. MD 12/28/1941 1093805012 310 CENTRAL AVENUE EAST ORANGE NJ 07018 DISQUALIFICATION 11/30/2014KHANTHAN, SUBRAMANIAM

MD 2/26/1942 1003882663 327 SCHUYLER AVENUE KEARNY NJ 07032 DISQUALIFICATION 5/20/2019

KHAPCHIK, DMITRY VIP CARE 1/18/1978 49 GATES COURT MATAWAN NJ 07747 DISQUALIFICATION 11/10/2019KHARKOVER, ALEKSANDR PT 2/13/1962 1861594889 FCI FORT DIX, PO BOX 2000 JOINT BASE MDL NJ 08640 DISQUALIFICATION 11/20/2013KHURANA, NORENDRA 8/15/1944 32 ROLLING HILLS LANE HARRISON NY 10528 DISQUALIFICATION 6/1/1993KIBALLO, MARIAN B. RN 10/29/1949 4 OJIBWA COURT WARETOWN NJ 08758 SUSPENSION 12/18/2003KIKTA, DANUTA RN 5/3/1969 593 GREENWICH COURT HIGHTSTOWN NJ 08520 DISQUALIFICATION 2/25/2019KILLEN, DAWN LPN 8/13/1961 804 COTSWOLD ROAD SOMERDALE NJ 08083 SUSPENSION 9/20/2006KILLMEYER, LINDA RN 5/12/1955 875 QUAKER CHURCH ROAD PERRYOPOLIS PA 15473 DISQUALIFICATION 12/29/2015KIM, DOYOUN MD 2/14/1924 545 KEARNY AVENUE KEARNY NJ 07032 SUSPENSION 10/30/1998KIM, DOYOUN MD 2/14/1924 2302 BAY HEAD DRIVE PARLIN NJ 08859 DISQUALIFICATION 7/13/1999KIM, JENNIFER J. RPH 10/13/1965 1117 INWOOD TERRACE FORT LEE NJ 07024 DEBARMENT 10/23/2003KIMBLE, OLLIE SABRINA 6/4/1965 341 OSBOURNE TERRACE, 2C NEWARK NJ 07106 DISQUALIFICATION 2/23/2009



58






EXPIRATION DATE

KIMMEL, STEVEN CONTRACTS MANAGER

420 DELAWARE STREET MINNEAPOLIS MN 55455 DEBARMENT 4/1/2002

KINDER, EDWARD P. 3/24/1965 5180 LA TERRA AVENUE PAHRUMP NV 89061 DEBARMENT 7/17/2009 7/17/2014KING, DEBORAH AKA LPN 5/10/1958 9 RADFORD PLACE WILLINGBORO NJ 08046 DISQUALIFICATION 10/18/2001 11/5/2018KING, JOHN ANDERSON DO 8/15/1958 11310 S. ORANGE BLOSSOM ORLANDO FL 23837 SUSPENSION 3/20/2007KING, WILLIAM MD 4/7/1945 1457411670 LEWISBURG USP, BOX 1000 LEWISBURG PA 17837 DISQUALIFICATION 8/20/2010KINGS PHARMACY 716 MARKET STREET GLOUCESTER NJ 08030 DISQUALIFICATION 12/29/2004KIRWIN, SHANNON RN 5/19/1973 114 NORTHMONT AVENUE MOUNT EPHRAIM NJ 08059 SUSPENSION 1/18/2007

KISSAM, JEFFREY 6/14/1955 1506 RUSTIC DRIVE OCEAN TOWNSHIP NJ 07712 DISQUALIFICATION 11/28/1992KLAUMENZER, JANE RN 12/7/1967 8 TENNESSEE AVENUE LONG BEACH NJ 08008 SUSPENSION 4/20/2003KLAUSNER, MARC RPH 10/5/1951 4515 BERGENLINE AVENUE UNION CITY NJ 07087 SUSPENSION 12/29/1999KLAUSS, GUNNAR MD 12/8/1970 1962685305 30 PROSPECT AVENUE HACKENSACK NJ 07601 DEBARMENT 8/1/2014 6/22/2017KLEES, DAVID DO 3/1/1957 1527 LINWOOD AVENUE ERIE PA 16510 DISQUALIFICATION 11/20/2015KLEINMAN, MARSHA PSYCH 4/20/1951 1043332893 32 NORTH 7TH AVENUE HIGHLAND PARK NJ 08904 DISQUALIFICATION 12/4/2012KLEINMAN, MARVIN AUDIOL 11/15/1950 1609995307 1 CLARIDGE DRIVE, APT. 508 VERONA NJ 07044 DISQUALIFICATION 2/11/2016KLEMMONS, IRA DDS 9/6/1948 1841393386 23 DEERPATH LANE COLTS NECK NJ 07722 DISQUALIFICATION 8/7/2017KLEYMAN, VLADIMIR RPH 4/5/1971 1386957710 3 CATHEDRAL DRIVE LAKEWOOD NJ 08701 DEBARMENT 1/23/2016KLEYMAN, VLADIMIR RPH 4/5/1971 1386957710 3 CATHEDRAL DRIVE LAKEWOOD NJ 08701 DISQUALIFICATION 5/12/2016KMET, BOGDAN 5/12/1984 363 EAST ROOSEVELT

BOULEVARDPHILADELPHIA PA 19120 DISQUALIFICATION 11/20/2015

KMET, NAZARIY 5/9/1978 2284 SANDTRAP ROAD JAMISON PA 18929 DISQUALIFICATION 11/20/2015KMET, ROSTISLAV 2/2/1989 13021 BLAKESLEE DRIVE, PHILADELPHIA PA 19116 DISQUALIFICATION 11/20/2015KOBYLECKYJ, CRYSTYNA RN 6/22/1965 35 WOODCOCK MOUNTAIN WASHINGTONVILLE NY 10992 DISQUALIFICATION 9/29/2017KOCH, MARK DO 9/9/1959 1528102647 336 BARNES ROAD MONROEVILLE AL 36460 DISQUALIFICATION 11/20/2015KOGAN, VADIM RN 9/2/1966 56 NORMANDY DRIVE PRINCETON JUNCT NJ 08550 SUSPENSION 12/18/2003KOHFELDT, LISA RN 3/19/1975 242 WEST FRONT STREET FLORENCE NJ 08518 DEBARMENT 2/7/2019KOLLMER, W. LANCE MD 6/3/1948 101 OLD SHORT HILLS ROAD WEST ORANGE NJ 07052 DEBARMENT 7/18/2001 DECEASEDKONNY, GREGORY RPH 6/13/1972 1396926432 990 CROMWELL ROAD WOODMERE NY 11598 DISQUALIFICATION 11/18/2021 PERMANENTKONTOS, DEMETRIUS D. MD 3/27/1935 463 TENAFLY ROAD ENGLEWOOD NJ 07631 SUSPENSION 2/20/2000



59






EXPIRATION DATE

KOPLITZ, MARSHALL 1/16/1960 256 NORWOOD AVENUE DEAL NJ 07723 SUSPENSION 12/10/1999KORNAK, PAUL H. MD 7/11/1951 FCI ELKTON, PO BOX 10 LISBON OH 44432 DISQUALIFICATION 4/19/2007KOSLOV, GLEB M. DC 9/30/1958 1366584583 388 RAMAPO VALLEY ROAD OAKLAND NJ 07436 DISQUALIFICATION 12/1/1998

KOSTER, LISA AKA LISA HENNESSEY

PA 4/20/1970 143737727 10 POSTOL ROAD CREAM RIDGE NJ 08514 DISQUALIFICATION 5/20/2021

KOTHALANKA, MD 6/14/1950 1184644080 562 SW ROMORA BAY PORT LUCIE FL 34986 DISQUALIFICATION 10/25/2016KOTTURI, SHIVA MD 2/15/1950 1013168251 512 KEARNY AVENUE, SUITE KEARNY NJ 07032 DISQUALIFICATION 6/17/2018 PERMANENTKOUSOULIDES, LOUISE RN 4/13/1961 34 TOPANEMUS LANE, APT. FREEHOLD NJ 07728 DISQUALIFICATION 4/20/2009KOUZMA, NATALIA CHHA 2/8/1971 122 CHELSEA WAY BRIDGEWATER NJ 08807 DISQUALIFICATION 2/8/2017KOVAR, GRACE M. RN 2/18/1956 929 CHELSEA DRIVE BRICKTOWN NJ 08724 SUSPENSION 5/19/2005KOWNACKY, MEGAN RN 7/9/1986 622 WALDEN WAY LUMBERTON NJ 08048 DISQUALIFICATION 8/28/2017KOZIUPA, HELENE A. LPN 1/19/1953 64 WESLEYAN DRIVE TRENTON NJ 08690 SUSPENSION 10/20/2002KRACKE, BARBARA LPN 12/26/1963 44 COVINGTON COURT EAST BRUNSWICK NJ 08816 DEBARMENT 11/13/2018KRAEMER, LINDA MARIE LPN 9/14/1967 436 SAINT ANDREW PLACE MANALAPAN NJ 07726 SUSPENSION 10/19/2006KRAKAUER, RANDALL MD 4/25/1949 1588811012 900 W MAIN STREET FREEHOLD NJ 07728 DISQUALIFICATION 2/25/1985KRAMER JR., EDWARD DC 7/26/1955 1285762401 106 MOTT ROAD BLAIRSTOWN NJ 07825 DISQUALIFICATION 9/28/2017 PERMANENTKRAMER, LARRY S. RPH 1/18/1963 650 PALISADES AVENUE ENGLEWOOD CLIFF NJ 07632 DISQUALIFICATION 1/10/2003KREISMAN, MARCIA 4/5/1956 8800 BOULEVARD EAST, APT. NORTH BERGEN NJ 07047 SUSPENSION 12/20/2004KRESKI, CHRISTINA RN 5/9/1985 2667 PAXTONVILLE ROAD MIDDLEBURG PA 17842 DISQUALIFICATION 12/29/2015KRICHEVSKY, RITA MD 4/5/1957 1851561963 4429 DRIFTWOOD DRIVE PHILADELPHIA PA 19129 DISQUALIFICATION 9/20/2017KRIVOSHIK, MARK MD 2/14/1959 1669409306 16 YEGER DRIVE ALLENTOWN NJ 08501 DISQUALIFICATION 11/20/2015 10/27/2020KROHN, IVAN T. MD 6/2/1943 1467429258 33 NORTHWOOD DRIVE VINELAND NJ 08360 DEBARMENT 5/20/2012

KROHN, IVAN T. MD 6/2/1943 1467429258 33 NORTHLAND DRIVE VINELAND NJ 08360 DISQUALIFICATION 4/20/2011KROMAH, ANGIE RN 1/5/1959 3206 LAWNDALE DRIVE EAST GREENSBORO SC 27408 DISQUALIFICATION 5/2/2017KROWICKI, JENNIFER AKA RN 7/6/1963 232 CLUB DRIVE WALL NJ 07719 SUSPENSION 10/20/2002KRUTOYARSKY, IRINA 2/23/1954 ALDERSON FPC, GLEN RAY ALDERSON WV 24910 DISQUALIFICATION 12/12/2016KUBACKI, JOSEPH MD 4/7/1949 1306834213 PO BOX 3949 PENSACOLA FL 32516 DEBARMENT 5/20/2013KUBLIN, ANNE MD 6/21/1960 182 WHALEPOND ROAD EATONTOWN NJ 07724 SUSPENSION 3/19/2004KUDLA, ALEXANDER LPN 3/3/1977 1449 LLOYD TERRACE MILLVILLE NJ 08332 DISQUALIFICATION 5/18/2019KUKASH, ABIGAIL 2/16/1967 6648 WEXFORD AVENUE RICHMOND VA 23255 DISQUALIFICATION 12/1/1998KUKASH, MAJDI 4/6/1970 87-02 PENNSBURY PLACE RICHMOND VA 23255 DISQUALIFICATION 12/1/1998



60






EXPIRATION DATE

KUKREJA, NAV R. MD 1/8/1958 1295739662 1331 COVENTRY COURT ISELIN NJ 08830 DEBARMENT 2/15/2016KULYK, ODARKA CHHA 10/19/1951 6 COLBY COURT LINCOLN PARK NJ 07035 DISQUALIFICATION 2/8/2017KUMAR, ANIL 7/1/1945 184 OLD BEEKMAN ROAD MONMOUTH NJ 08852 DISQUALIFICATION 1/14/2005KUMAR, SAROJ 1/22/1954 184 OLD BEEKMAN ROAD MONMOUTH NJ 08852 DISQUALIFICATION 1/14/2005KUNZ, BARBARA RN 7/18/1974 55 THIRD STREET NEW YORK NJ 10956 DEBARMENT 8/21/2018 10/21/2021KURAN, BASSEM 10/28/1992 FCI FAIRTON, PO BOX 420 FAIRTON NJ 08320 DISQUALIFICATION 8/7/2017KURBAN, HAKAN 3/28/1969 41 SIDNEY AVENUE RUTHERFORD NJ 07070 DISQUALIFICATION 6/22/1999KURIAN, LISSYAMMA RN 9/1/1976 1253 COLLIDGE AVENUE UNION NJ 07083 SUSPENSION 10/20/2002KURIS, JAY MD 9/14/1944 1003997453 160 MONTDALE DRIVE PRINCETON NJ 08540 DISQUALIFICATION 1/18/2019KURLANDER-ZAKARIA, TRACI

RN 3/20/1962 20 ROCK ROYAL ROAD TRENTON NJ 08620 DISQUALIFICATION 2/26/2010

KURTZ, JOEL P. DMD 10/1/1944 1285874743 9 WESTGATE ROAD LIVINGSTON NJ 07039 SUSPENSION 5/19/2005KUSHMAN, JOSEPH MD 8/21/1972 1205025541 224 COLONIAL AVENUE UNION NJ 07083 DISQUALIFICATION 6/28/2017KUSHNER, ALAN DC 10/8/1950 1558398396 SCI GRATERFORD, JG1165,

PO BOX 244GRATERFORD PA 19426 DISQUALIFICATION 11/20/2015

KUYINU, MICHAEL MD 9/28/1947 1235173568 34 VANDERVEER DRIVE BELLE MEAD NJ 08502 DEBARMENT 12/16/2015KYMER, RHIANNON RN 4/1/1980 8 SPENCER LANE WARREN NJ 07059 DISQUALIFICATION 3/27/2018LABORDE, JAMES DC 6/3/1955 1578541504 329 SOUTH HIGHLAND DUBOIS PA 15801 DISQUALIFICATION 11/20/2015LABOY, MICHELLE LPN 9/17/1974 71 LYCEUM COURT STATEN ISLAND NY 10310 DISQUALIFICATION 5/2/2017 11/2/2017LABRUNA, VINCENT DDS 12/12/1960 1801192216 227 EAST 19TH STREET NEW YORK NY 10003 DISQUALIFICATION 7/22/2002 1/29/2018LABRUNA, VINCENT DDS 12/12/1960 1801192216 227 EAST 19TH STREET NEW YORK NY 10003 SUSPENSION 9/19/2002 1/29/2018LACEY, JOAN R. RN 12/4/1947 479 INNES ROAD WOODRIDGE NJ 07075 SUSPENSION 10/19/2000LACRICCHIO, RICHARD C. 150 ROUTE 150 DENVILLE NJ 07834 DISQUALIFICATIONLAFON, MICHAEL MD 1/28/1958 1609168715 107 E. MANTUA AVENUE WENONAH NJ 08090 DISQUALIFICATION 3/28/2004 2/16/2015LAGRADA, WILLIAM MD 7/6/1960 1316996762 1300 MAIN STREET, STE. 2D CLIFTON NJ 07011 SUSPENSION 2/15/2012 9/25/2014LAGRADA, WILLIAM MD 7/6/1960 1316996762 15 FORSYTHIA DRIVE EDISON NJ 08837 DEBARMENT 9/25/2014LAGUERRE, JEAN RPH 9/19/1968 1 62ND STREET, APT. 4C WEST NEW YORK NJ 07093 DEBARMENT 8/16/2007LAGUERRE, JEAN RPH 9/19/1968 1 62ND STREET, APT. 4C WEST NEW YORK NJ 07093 DISQUALIFICATION 2/29/2008LAI, MYUNG-OK RN 9/12/1974 40 PONY LANE FLEMINGTON NJ 08822 DISQUALIFICATION 9/13/2018 6/27/2019LAIDO, JOSEPH CHHA 8/27/1964 722 SIXTH STREET LYNDHURST NJ 07071 DISQUALIFICATION 2/8/2017LAJEWSKI, WAYNE MD 1/17/1963 1558364166 FCI FORT DIX, PO BOX 2000 JOINT BASE MDL NJ 08640 DISQUALIFICATION 10/20/2015

LALLEMAND JR., ROGER MD 1/7/1973 1770575821 4 TYCOR COURT HOLMDEL NJ 07733 DISQUALIFICATION 12/20/2014LAM, MICHAEL CHUNG MD 2/19/1966 1184656050 1625 ANDERSON AVENUE FORT LEE NJ 07024 DEBARMENT 3/6/2014



61






EXPIRATION DATE

LAM, MICHAEL CHUNG MD 2/19/1966 1184656050 2 8TH STREET ENGLEWOOD CLIFF NJ 07632 DISQUALIFICATION 11/14/2014LAMBRIOLA, VINCENT P. DDS 5/1/1956 143 LITTLE FALLS CEDAR GROVE NJ 07009 DISQUALIFICATION 2/20/2001LAMP, REBECCA RN/CNP 2/14/1963 1568511236 139 DERWOOD DRIVE NEW CUMBERLAND WV 26407 DISQUALIFICATION 11/20/2015LAMPARELLI, NICHOLAS RPH 11/10/1935 149 SUMMIT AVENUE ISLAND HEIGHTS NJ 08732 DISQUALIFICATION 4/30/2003LAMPHIER, JENNIFER DMD 7/26/1968 1487860649 38 SILVERSIDE ROAD LAKEWOOD NJ 08701 DISQUALIFICATION 10/23/2019LAMPROU JR., EMANUEL MD 9/9/1953 1033104526 509 N. BROAD STREET WOODBURY NJ 08096 DEBARMENT 12/18/2012 12/18/2015LANCE-LANNIGAN, JUDITH

8/27/1955 12 PROSPECT HILL FLEMINGTON NJ 08822 DISQUALIFICATION 7/23/2010 DECEASED

LANDOU, LISSA S. DC 5/1/1959 17B 16TH AVENUE ELMWOOD PARK NJ 07407 SUSPENSION 4/18/2002LANE, EDWIN MD 1/13/1943 BEACHWOOD NJ 08722 DISQUALIFICATION DECEASEDLANG, ANTHONY 12/19/1979 151 SOUTH DURAND PLACE IRVINGTON NJ 07111 DISQUALIFICATION 10/19/2009 10/19/2014LANG, BRIAN E. LPN 3/2/1965 634 SPROUL STREET CHESTER PA 19013 SUSPENSION 3/20/2006LANG, DEBRA CHHA 9/1/1958 124 VAN BUSKIRK ROAD TEANECK NJ 07666 SUSPENSION 10/20/2002LANGERAAP, JOHN MD 7/21/1978 1720299092 198 WHITE LAKE ROAD LAFAYETTE NJ 07848 DISQUALIFICATION 6/26/2018LANGERAAP, JOHN MD 7/21/1978 1720299092 289 WEST MOUNTAIN ROAD SPARTA NJ 07871 DISQUALIFICATION 9/12/2020LANGLIEB, MARTIN S. DDS 12/11/1931 94 MIDLAND AVENUE FAIRLAWN NJ 07410 DEBARMENT 8/25/1999LANNON, JENNIFER RN 4/22/1981 520 COLLINGS AVENUE COLLINGSWOOD NJ 08108 DISQUALIFICATION 6/4/2018LAPORTE, EDYNE RN/LPN 2/8/1979 1107 FURTH ROAD VALLEY STREAM NY 11581 SUSPENSION 9/27/2007LASHKEVICH, JOHN P. 11/20/1959 9 CHARLES LANE CHERRY HILL NJ 08003 SUSPENSION 5/8/1998LASTIVKA, MARTA CHHA 1/11/1958 28 WINDING WOOD, APT. 2- SAYREVILLE NJ 08872 DISQUALIFICATION 2/8/2017LASTRA, ABRAHAM 2/12/1970 500 HIGHLAND AVENUE NEWARK NJ 07102 DISQUALIFICATION 4/15/1999LASTRA, ABRAHAM 2/12/1970 1808 BERGENLINE AVENUE UNION CITY NJ 07087 SUSPENSION 12/20/2010

LATAWIEC, ANDREA RN 3/7/1964 1681 RARITAN ROAD CLARK NJ 07066 SUSPENSION 5/20/2002LATCHMAN, BHANWATIE PHARM 4/9/1977 76 WATSON AVENUE EAST ORANGE NJ 07052 DEBARMENT 5/16/2016LAURIA, SHANNON CHHA 4/7/1974 86 FORT DE FRANCE AVENUE TOMS RIVER NJ 08757 DISQUALIFICATION 4/7/2017LAURITANO, LAURA RN 9/4/1971 47 OLD ORCHARD COURT CEDAR GROVE NJ 07009 DISQUALIFICATION 6/28/2017 8/2/2019LAVELLE, BARBARA RN/APN 8/28/1958 550 LINCOLN AVENUE RIDGEFIELD NJ 07657 SUSPENSION 12/18/2003LAVNEVICH, NAUM CHHA 6/21/1967 11 HIAWATHA BOULEVARD OAKLAND NJ 07436 SUSPENSION 11/4/2014LAVNEVICH, NAUM CHHA 6/21/1967 11 HIAWATHA BOULEVARD OAKLAND NJ 07436 DISQUALIFICATION 2/11/2016LAZOW, SOLOMON M. MD 6/17/1902 199 MAIN STREET MATAWAN NJ 07747 DISQUALIFICATION 6/1/1993LEATHERDALE, LAURA CHHA 8/27/1982 4 MEETINGHOUSE ROAD WRIGHTSTOWN NJ 08562 SUSPENSION 9/19/2003LEBAK, STEPHANIE APN/RN 7/15/1989 1790114965 92 EATON ROAD BORDENTOWN NJ 08505 DISQUALIFICATION 6/29/2019LEE JR., SAMUEL RPH 8/19/1940 34 PINAFORE LANE WILLINGBORO NJ 08046 DISQUALIFICATION 7/30/1997



62






EXPIRATION DATE

LEE, AUGUSTINE MD 10/11/1942 1255478269 905 STUYVESANT AVENUE TRENTON NJ 08618 SUSPENSION 12/22/2011LEE, AUGUSTINE MD 10/11/1942 1255478269 PO BOX 329002 BROOKLYN NY 11232 DEBARMENT 10/29/2013LEE, BRIAN LPN 2/13/1968 1722 COPE STREET CAMDEN NJ 08104 SUSPENSION 10/20/2002 8/9/2013LEE, BRIAN LPN 2/13/1968 1722 COPE STREET CAMDEN NJ 08104 DEBARMENT 7/18/2018 LEE, CHANG HO MD 12/16/1946 1679795181 535A 7TH STREET PALISADES PARK NJ 07650 DISQUALIFICATION 7/20/2015LEE, DAVID MD 9/24/1957 1275633562 46 CONSTITUTION DRIVE SOUTHAMPTON NJ 08088 DISQUALIFICATION 12/22/2016 PERMANENTLEE, LAURA 1/7/1960 7280 LEMINGTON AVENUE PITTSBURGH PA 15206 DISQUALIFICATION 11/20/2015

LEE, STEVE Y. DDS 2/10/1961 1219 MAIN AVENUE CLIFTON NJ 07111 SUSPENSION 7/19/2001LEE, SYLVIA S. MD 9/22/1952 1275518490 27 SUNSET PLACE EMERSON NJ 07630 DEBARMENT 8/26/2013LEEDS, GARY MD 6/27/1953 1316005036 77 WEST 15TH STREET, APT. NEW YORK NY 10011 DEBARMENT 11/21/2016LEEDS, GARY MD 6/27/1953 1316005036 16 ELIZABETH LANE RIVERSIDE CT 06878 DISQUALIFICATION 5/24/2017LEIBER, CHARLES 12/29/1938 5804 BOARDWALK, APT. 104 VENTOR NJ 08406 SUSPENSION 5/22/2007LEIBMAN, JOSEPH B. MD 5/30/1960 PO BOX 1005 PORT JERVIS NY 12771 DEBARMENT 6/22/2000LEISER, SHAUL RN 5/23/1983 14 HICKORY HILL ROAD JACKSON NJ 08527 DEBARMENT 12/7/2018 6/8/2021LEKWAUWA, RN 1/1/1967 1643 PARK STREET RAHWAY NJ 07065 DEBARMENT 8/28/2017 6/4/2019LEON, JACK 6/9/1965 2991 E. CHESTNUT AVENUE, VINELAND NJ 08360 DISQUALIFICATION 2/22/2000LEON, JACK 6/9/1965 1071 E. LANDIS AVENUE VINELAND NJ 08360 SUSPENSION 6/29/1998LEONARD, BARRY A. MD 3/6/1942 15 DARIEN DRIVE CHERRY HILL NJ 08003 DISQUALIFICATION 2/13/1996LEONARD, JUDITH RPH 12/10/1958 70 LAUREL DRIVE LITTLE SILVER NJ 07739 SUSPENSION 2/20/2005LEONARD, TROY COUNSE

LOR12/26/1983 1851691448 999 COLONIAL ROAD FRANKLIN LAKES NJ 07417 DISQUALIFICATION 11/22/2016 PERMANENT

LEPKO, ERVIN MD 2/11/1928 18 JANE DRIVE ENGLEWOOD NJ 07632 SUSPENSION 5/20/2002LERNER, ELIZABETH 8/8/1967 ALDERSON FPC, GLEN RAY ALDERSON WV 24910 SUSPENSION 7/20/2008LERNER, MARVIN H. MD 9/20/1944 1321 WASHINGTON STREET HOBOKEN NJ 07030 DISQUALIFICATION 3/5/2002

LESLIE, GLENN R. DO 11/19/1954 1285712950 10 FRANKLIN TURNPIKE MAHWAH NJ 07430 SUSPENSION 4/3/2014 11/20/2015LESLIE, GLENN R. DO 11/19/1954 1285712950 245 WOODLAND AVENUE RAMSEY NJ 07446 DEBARMENT 11/20/2015LESLIE, GLENN R. DO 11/19/1954 1285712950 FMC - LEXINGTON, PO BOX

14500LEXINGTON KY 40512 DISQUALIFICATION 1/9/2016

LETREN, DENISE CHHA 2/3/1956 916 MADISON AVENUE UNION NJ 07083 DISQUALIFICATION 1/15/2021LEVELL, CRYSTAL LPN 3/7/1972 143 N. 12TH STREET NEWARK NJ 07107 SUSPENSION 8/20/2001 7/23/2012



63






EXPIRATION DATE

LEVIN, HARVEY M. MD 3/19/1935 510 NORTH KINGS HIGHWAY CHERRY HILL NJ 08034 DISQUALIFICATION 6/1/1993

LEVINE, EDWARD J. MD 12/27/1951 7 GREEN HILL ROAD COLTS NECK NJ 07722 SUSPENSION 6/22/1999 7/21/2020LEVY, EDWARD E. DDS 5/3/1964 108-34 67TH AVENUE FOREST HILLS NY 11375 DEBARMENT 12/29/2011LEVY, RICHARD S. DPM 1/8/1953 177 MAIN STREET, SUITE 235 FORT LEE NJ 07024 SUSPENSION 12/20/2001

LEWANDOWSKI, DO 9/16/1963 1114070398 100 ATLANTIC AVENUE CAMDEN NJ 08101 DEBARMENT 8/28/2014LEWANDOWSKI, KENNETH

DO 9/16/1963 1114070398 24 PEACH BLOSSOM LANE MIDDLETOWN NJ 07748 DISQUALIFICATION 11/20/2015

LEWANDOWSKI, DO 9/16/1963 1114070398 24 PEACH BLOSSOM LANE MIDDLETOWN NJ 07748 DEBARMENT 6/30/2016 PERMANENTLEWIN, TASHEIKA CHHA 12/13/1990 139 B 14TH AVENUE ELMWOOD PARK NJ 07407 DISQUALIFICATION 7/14/2017 8/21/2018LEWIS, ERICA CHHA 1/13/1989 1098 PENNSYLVANIA FRANKLINVILLE NJ 08322 DISQUALIFICATION 1/29/2018LEWIS, TOLIA CHHA 2/6/1990 391 ISABELLA AVENUE IRVINGTON NJ 07111 DISQUALIFICATION 9/19/2017LEYBA, ROGELIO 3/1/1973 24 WEBSTER STREET NEWARK NJ 07104 DISQUALIFICATION 2/11/2016LEYSON, JOSE MD 8/17/1946 1528169539 6 RANNEY ROAD LONG VALLEY NJ 07853 DISQUALIFICATION 10/3/2019 LEYSON, JOSE MD 8/17/1946 1528169539 6 RANNEY ROAD LONG VALLEY NJ 07853 DISQUALIFICATION 6/30/2018 PERMANENTLI, STAN MD 2/10/1954 1386631794 16 SECRETARIO WAY HAMILTON NJ 08690 DISQUALIFICATION 8/20/2015 PERMANENTLI, STAN MD 2/10/1954 1386631794 16 SECRETARIO WAY HAMILTON NJ 08690 DISQUALIFICATION 11/18/2015 PERMANENTLIBRIZZI, MICHELLE H. LPN 3/25/1961 5 BELLIS COURT RINGOES NJ 08551 DISQUALIFICATION 7/18/2001

LICKFIELD, KEVIN J. DO 1/19/1962 524 JUSTICE DRIVE MARLTON NJ 08053 DISQUALIFICATION 3/3/2003LIEBOWITZ, LEONARD J. MD 10/26/1949 5 POE COURT MORGANVILLE NJ 07741 DEBARMENT 8/18/2001LIFE CARE HOME 1972641496 2127 NORTH 6TH STREET PHILADELPHIA PA 19122 DISQUALIFICATION 12/29/2015LIFE SUPPORT 1659699049 CI MOSHANNON VALLEY, 555 PHILLIPSBURG PA 16866 DISQUALIFICATION 12/29/2015LILLO, CHRISTOPHER T. DMD 10/1/1967 1720150675 191 HIGHWAY 37 WEST TOMS RIVER NJ 08755 DISQUALIFICATION 12/20/2012LIMIDO, GLEN CARL RPH 11/7/1940 1 EAST PLEASANT AVENUE MAYWOOD NJ 07607 SUSPENSION 10/19/2006LIMONGELLI, WILLIAM DDS 12/27/1943 1184796534 679 SO. ORANGE AVENUE NEWARK NJ 07106 DISQUALIFICATION 10/30/1986LINDER, NORBERT MD 4711 BERGENLINE AVENUE UNION CITY NJ 07087 DISQUALIFICATION 3/23/1977LINK, TIMOTHY MD 10/2/1972 1477767705 63 MONMOUTH PARKWAY MONMOUTH BEACH NJ 07750 DISQUALIFICATION 2/5/2018LIPMAN, CLIFFORD R. MD 1/6/1951 1083676670 26 UNION AVENUE FREEHOLD NJ 07728 DEBARMENT 1/16/2015 5/30/2018



64






EXPIRATION DATE

LIPPIELLO, JENNIE A. DC 6/29/1955 1366605966 2920 ROUTE 23 SOUTH NEWFOUNDLAND NJ 07435 SUSPENSION 4/19/2001LIPSON, PHILIP A. DO 4/21/1950 38 W. NORTON DRIVE SOUTHAMPTON PA 18966 DISQUALIFICATION 10/19/2005LIRIANO, ANGELA CHHA 1/4/1959 79 CLINTON AVENUE, APT #2 JERSEY CITY NJ 07306 DISQUALIFICATION 11/22/2017 PERMANENTLIRIANO, ANGELA CHHA 1/4/1959 79 CLINTON AVENUE, APT #2 JERSEY CITY NJ 07306 DISQUALIFICATION 7/14/2017LIRIANO, ANGELA CHHA 1/4/1959 79 CLINTON AVENUE, APT #2 JERSEY CITY NJ 07306 DISQUALIFICATION 4/19/2018

LIVSHITS, BORIS 12/14/1969 1935 83RD STREET APT. E6 BROOKLYN NY 11214 DISQUALIFICATION 8/1/2009LIVSHITZ PHARMACY INC. 203 16TH AVENUE NEWARK NJ 07103 DISQUALIFICATION 5/21/1980LIZIK, MICHELLE LPN 1/10/1970 451 FULLERTON AVENUE CAMBRIDGE SPRINGS PA 16403 DISQUALIFICATION 11/20/2015LLANOS, LATOYA CHHA 8/15/1977 433 W. QUINCE STREET VINELAND NJ 08360 DEBARMENT 3/29/2002LOAIZA, ERIKA CHHA 5/2/1991 206 COVENTRY LANE SOMERSET NJ 08873 DISQUALIFICATION 2/8/2017LOBO, ANGEL R. MD 12/4/1932 661 14TH AVENUE PATERSON NJ 07504 DEBARMENT 6/11/2002LOBO, ANGEL R. MD 12/4/1932 398 STEWART AVENUE GARDEN CITY NY 11530 SUSPENSION 5/20/2007LOBO, MERCY 11/1/1941 22 HELEN PLACE CLIFTON NJ 07011 DISQUALIFICATION 4/23/2007LOCK, ABRAHAM J. MD 9/5/1941 1801 AVENUE J BROOKLYN NY 12230 DEBARMENT 2/25/2001LOCURATOLO, LUIS R. MD 12/15/1929 104-01 ROOSEVELT AVENUE CORONA NY 11368 SUSPENSION 12/1/1995LOGAN, JEANETTE E. RN 9/5/1953 12 ARAGON COURT TRENTON NJ 08628 SUSPENSION 5/20/2004LOLL-VAN SICKLE, RN 9/27/1953 416 SALEM STREET ELMER NJ 08318 SUSPENSION 4/20/2000LOPEZ, JOHN J. 3/28/1967 428 N 16TH STREET KENILWORTH NJ 07033 DEBARMENT 12/11/2001LOPEZ, JOSE A. MD 8/28/1962 24 WOODLAND ROAD BLOOMFIELD NJ 07003 SUSPENSION 11/20/2006LOPEZ, JULIANA CHHA 7/8/1987 236 GRAND AVENUE CAMDEN NJ 08105 DISQUALIFICATION 2/8/2017LOPEZ-FALCONE, JUAN 8/23/1954 8385 SW 43RD STREET MIAMI FL 33155 DISQUALIFICATION 5/2/2003LOPRESTI, JACQUELINE A. DO 12/30/1960 1043348220 568 RIDGE ROAD FAIR HAVEN NJ 07704 SUSPENSION 12/20/2011

LOPRESTI, JACQUELINE A. DO 12/30/1960 1043348220 ALDERSON FPC, GLEN RAY ALDERSON WV 24910 DISQUALIFICATION 3/20/2014LOTTERMAN, RANDEE RN 7/10/1985 6 JUNIATA STREET WEST MILFORD NJ 07480 DISQUALIFICATION 6/15/2017LOUIS-BAPTISTE, CHHA 5/2/1979 51 LINCOLN STREET EAST ORANGE NJ 07017 DISQUALIFICATION 10/20/2017LOUISSAINT, PARACLET MD 7/8/1948 1164519179 669 ELIZABETH AVENUE NEWARK NJ 07112 DEBARMENT 1/1/2001 1/11/2017

LOUKHNATI, RAJAA CHHA 10/12/1973 5 COLGATE DRIVE CHERRY HILL NJ 08034 DEBARMENT 2/20/2017LOVETT, BETTIE CHHA 10/17/1950 212 SENACA TRAIL BROWNS MILLS NJ 08064 DEBARMENT 5/28/2013LOWELL-SENTURIA, LISA MD 4/2/1967 DOGWOOD TRAIL RANDOLPH NJ 07869 SUSPENSION 11/20/2008LOWREY, RODNEY 2/13/1945 88 3RD AVENUE ATLANTIC HIGHLANDS NJ 07716 DISQUALIFICATION



65






EXPIRATION DATE

LUCA, BONNIE J. 9/15/1962 1016 WASHINGTON WASHINGTON NJ 07882 DEBARMENT 6/10/2007LUCAS, KATINA RN 4/29/1960 126 LAGUARDIA AVENUE STATEN ISLAND NY 10314 SUSPENSION 10/19/2006LUDDEN, JAMES W. DPM 2/5/1963 1720054935 23 SOCIETY HILL WAY TINTON FALLS NJ 07724 DISQUALIFICATION 6/8/2007LUDDEN, JAMES W. DPM 2/5/1963 1720054935 23 SOCIETY HILL WAY TINTON FALLS NJ 07724 DISQUALIFICATION 12/19/2016LUDWICK, DONNA RN 7/4/1966 7 DEER VALLEY LANE, UNIT VERNON NJ 07462 DISQUALIFICATION 6/22/2019LUDWIKOWSKI, MICHAEL RPH 2/18/1972 113 DIXONTOWN ROAD MEDFORD NJ 08055 DISQUALIFICATION 4/13/2018LUDWIKOWSKI, MICHAEL RPH 2/18/1972 FCI LORETTO, PO BOX 1000 CRESSON PA 16630 DISQUALIFICATION 5/14/2021LUNDY, HOWARD 4/26/1955 1 MALKE DRIVE OCEAN NJ 07712 DEBARMENT 4/4/2015LYNCH, CHRISTOPHER MD 1/25/1950 1407813975 1719 PENN CROSSING ALLENTOWN PA 18104 DISQUALIFICATION 11/20/2015LYNCH, KATHRYN LPN 7/30/1968 33 STEVENS TERRACE SOUTH PLAINFIELD NJ 07080 DISQUALIFICATION 2/7/2019LYONS, DANA LPN 4/29/1963 245 4TH AVENUE ROEBLING NJ 08554 SUSPENSION 2/20/2002LYONS-VALENTI, ASHLEY APN/RN 12/7/1956 1275715179 119 PALMER PLACE SWEDESBORO NJ 08085 DISQUALIFICATION 10/4/2020 PERMANENT

LYVAN, KIM DDS 9/19/1955 1346458965 199 CANAL STREET, #201 NEW YORK NY 10013 SUSPENSION 11/27/2000M & G LIVERY CO., INC. 6 PLEASANT VALLEY WAY WEST ORANGE NJ 08052 SUSPENSION 6/19/2003M & G TRANSPORTATION 269 SHEFFIELD STREET MOUNTAINSIDE NJ 07092 DEBARMENT 10/31/2002M & M MEDICAL LIVERY 64 BEVAN STREET JERSEY CITY NJ 07306 DISQUALIFICATION 5/31/1994MAAT, THOMAS P. LPN 10/17/1969 2311 4TH AVENUE TOMS RIVER NJ 08753 SUSPENSION 3/18/2004MABRY, MYRA ANN CUMMINGS

MD 7/24/1969 1306070719 GLEN RAY ROAD, BOX A ALDERSON WV 24910 DISQUALIFICATION 7/20/2021 PERMANENT

MACH, PHILIP C. MD 9/26/1957 1770562993 PO BOX 1000 LORETTO PA 15940 SUSPENSION 5/9/2008MACH, PHILIP C. MD 9/26/1957 1770562993 30 DANIEL DRIVE FRANKLIN PARK NJ 08823 DISQUALIFICATION 10/7/2008MACH, PHILIP C. MD 9/26/1957 1770562993 17 SHELDON ROAD PEMBERTON NJ 08068 DISQUALIFICATION 10/30/2018 PERMANENTMACIAS, ERICK DC 5/5/1985 1215311329 111 E. DEWEY AVENUE, APT. WHARTON NJ 07885 DISQUALIFICATION 7/24/2020MADDOX, CALISA CHHA 5/12/1977 42 TRITON TERRACE NEWARK NJ 07104 DISQUALIFICATION 9/20/2019MADDOX, PEARL V. CHHA 9/8/1968 KINSLEY ROAD PEMBERTON NJ 08068 DISQUALIFICATION 9/25/2007MAHAJAN, SHYAM S. MD 3/18/1945 1144496449 7624-A BRISLIN ROAD, #7 STROUDSBURG PA 18360 DISQUALIFICATION 12/1/1998MAHARAJ, GANGARAM RPH 11/23/1957 1326323106 72 VAN REIPEN AVENUE JERSEY CITY NJ 07306 DISQUALIFICATION 7/22/2017MAHER, PATRICIA RN 10/25/1958 26 PROSPECT STREET RAMSEY NJ 07446 DISQUALIFICATION 2/7/2019MAHGOUB, ADAM 1/1/1961 1995 JFK BOULEVARD, #14 JERSEY CITY NJ 07305 DISQUALIFICATION 6/17/2002MAHMOOD, SHAHID 4/3/1960 228 GRAND STREET JERSEY CITY NJ 07302 DEBARMENT 3/30/2010MAHMUD, ASIF MD 2/17/1967 2024 W. 13TH STREET BROOKLYN NY 11223 SUSPENSION 3/18/2004MAIGUE, LLEWELYN RN 11/30/1960 6 CRYSTAL AVENUE WEST ORANGE NJ 07052 SUSPENSION 4/19/2001MAIN PHARMACY, LLC 1861705873 80 SOUTH MAIN ROAD, VINELAND NJ 08360 DISQUALIFICATION 4/13/2018



66






EXPIRATION DATE

MAIORANO, JOHN RPH 2/13/1951 1659492940 345 UNION HILL ROAD ENGLISHTOWN NJ 07726 DISQUALIFICATION 7/11/2000MAIORANO, JOHN RPH 2/13/1951 1659492940 123 EAST END AVENUE ISLAND HEIGHTS NJ 08732 SUSPENSION 4/18/2002MAIS, JENNIFER C. PA 12/1/1964 1801035084 22 NEW STREET HILLSDALE NJ 07642 DISQUALIFICATION 4/30/2015MAKKER, RAM S. MD 4/13/1950 1538117213 52 SNAPDRAGON LANE ROSLYN HEIGHTS NY 11577 DISQUALIFICATION 4/20/2010MALADY, SUSAN AKA RN 3/31/1949 PO BOX 468 BLAIRSTOWN NJ 07825 SUSPENSION 6/20/2001MALAMUD, YAFIM 2/4/1942 177 SARGEANT AVENUE CLIFTON NJ 07013 DEBARMENT 8/8/2003MALDONADO, CHEYENNE PHARM

TECH9/22/1991 3 DUKE DRIVE TOMS RIVER NJ 08757 DEBARMENT 1/5/2017

MALDONADO, SANDRA CHHA 5/9/1970 2808 CONGRESS ROAD CAMDEN NJ 08104 DISQUALIFICATION 3/6/2018MALDONADO, TOSHIRA CHHA 1/11/1980 4648 THELMA AVENUE MAYS LANDING NJ 08330 DEBARMENT 1/20/2017MALIK, ATIF MD 10/27/1969 FCI LORETTO, PO BOX 1000 LORETTO PA 15940 DISQUALIFICATION 3/1/2019MALIK, MOHAMMAD S. 5/15/1960 146 OLD COURTHOUSE MANHASSETT NY 11400 SUSPENSION 9/22/2000MALIK, MOHAMMAD S. 5/15/1960 146 OLD COURTHOUSE MANHASSETT NY 11040 SUSPENSION 10/20/2002MALLOY, TIFFANY APN/RN 9/30/1970 1790910503 34 VIBURNUM COURT LAWRENCEVILLE NJ 08648 DEBARMENT 8/28/2017MALLOZZI, DEBORAH RN 9/9/1964 1603 PERSHING AVENUE FORKED RIVER NJ 08731 DISQUALIFICATION 6/28/2017MANALO, JERICHO RN 6/30/1989 22 PINE STREET BLOOMFIELD NJ 07109 DISQUALIFICATION 11/13/2017MANCILLA, MARIA CHHA 4/24/1956 284 REDMOND STREET NEW BRUNSWICK NJ 08873 SUSPENSION 5/14/2007MANCINI, ANGELO D. RPH 8/1/1950 SKEET & DIXONTOWN ROAD MEDFORD NJ 08055 DISQUALIFICATION 7/1/1985

MANFORD, ROSE AKA CHHA 10/1/1984 5507 WARNER VIEW LANE WESTVILLE OH 43081 DEBARMENT 7/13/2018MANFRE, MARIA LPN 9/26/1986 262 N. MIDDLESEX COURT THOROFARE NJ 08086 DISQUALIFICATION 6/5/2017MANGIONE, MICHELE RN 10/24/1954 35 LONGVIEW DRIVE WALDWICK NJ 07363 SUSPENSION 9/20/2004MANIN, LAWRENCE 611 BURLINGTON MOUNT HOLLY NJ 08060 DISQUALIFICATION 4/12/1993MANION, WILLIAM MD 8/12/1952 1134120801 33 MEADOW DRIVE WOODSTOWN NJ 08098 DISQUALIFICATION 3/8/2018MANJO, EUNICE AKA RN 7/4/2969 128 FIELDBROOK DRIVE MAGNOLIA DE 19962 DISQUALIFICATION 10/3/2019MANKOFF, BERNARD GREEN GROVE ROAD NEPTUNE NJ 07753 DISQUALIFICATIONMANNAVA, VENKATA RPH 10/18/1969 1356478895 3300 EAST WEST HIGHWAY HYATTSVILLE MD 20782 DISQUALIFICATION 6/30/2016MANNING, LUTHER 3/21/1955 586 WEST SCOTT AVENUE RAHWAY NJ 07065 SUSPENSION 10/20/2008MANNO, MICHAEL DC 5/14/1969 1356704738 PO BOX 1000 FORT DIX NJ 08640 SUSPENSION 10/20/2003MANSOUR, ALI MD 3/17/1968 1346225885 225 DEMOTT LANE SOMERSET NJ 08873 DEBARMENT 12/20/2014 10/25/2019MANZE, PATRICK MD 7/28/1946 53 GARDNER AVENUE CHATHAM NJ 07928 SUSPENSION 2/20/2005 DECEASEDMANZELLA, JOHN DO 7/15/1964 680 BROADWAY AVENUE PATERSON NJ 07514 DEBARMENT 6/28/2014MANZI, JOHN J RPH 6 TEMPLE ROAD, APT 22 C VINELAND NJ 08360 DISQUALIFICATION 6/1/1993



67






EXPIRATION DATE

MANZONI, JANET M. DC 4/27/1955 1851497168 52 TENNET ROAD MORGANVILLE NJ 07751 SUSPENSION 2/3/1998MANZONI, JANET M. DC 4/27/1955 1851497168 9 KILMER DRIVE MANALAPAN NJ 07726 DISQUALIFICATION 5/20/2009MARC, DAMILOLA LPN 11/26/1986 165 FULTON AVENUE, APT. 3 JERSEY CITY NJ 07305 DISQUALIFICATION 11/23/2019MARCELL, JOSEPH A. 12/15/1928 305 MAIN STREET RIDGEFIELD PARK NJ 07660 DISQUALIFICATION DECEASEDMARCHAND, ANTHONY MD 11/4/1944 19 DEXTER DRIVE NORTH BASKING RIDGE NJ 07920 SUSPENSION 9/19/2003MARCHETTA, LEONARD PA 12/5/1966 1720196140 FCI FORT DIX, PO BOX 2000 JOINT BASE MDL NJ 08640 DISQUALIFICATION 6/3/2016

MARCOS, FRANCISCO RPH 12/10/1975 1699158063 777 CHARNWOOD DRIVE WYCKOFF NJ 07481 DISQUALIFICATION 9/20/2011 4/5/2017MARCUS, ALAN L. DC 11/22/1951 789 CLIFTON AVENUE CLIFTON NJ 07013 DISQUALIFICATION 7/25/2001MARKOFF, MORTON DO 10/9/1940 908 FRANCINE DRIVE CHERRY HILL NJ 08003 SUSPENSION 11/7/1997 DECEASEDMARKOSOVA, GRETA CHHA 1/3/1961 2301 WESTMINSTER PARLIN NJ 08859 DISQUALIFICATION 1/31/2017MARON, ANDREW DDS 6/12/1961 1215035134 326 BROAD STREET RED BANK NJ 07011 DISQUALIFICATION 10/21/2015MARON, ANDREW DDS 6/12/1961 1215035134 16041 LOCH KATRINE TRAIL,

APT. 7501LAKE WORTH FL 33467 DISQUALIFICATION 11/1/2019

MARONPOT, BARBARA DDS 12/20/1953 1821203696 281 MENDHAM ROAD BERNARDSVILLE NJ 07924 DEBARMENT 3/17/2015MARQUEZ, MANUEL S. MD 6/5/1925 112 DOWNING COURT MOUNT LAUREL NJ 08054 DISQUALIFICATION 12/5/1997 DECEASEDMARQUEZ, OLGA COUNSE

LOR2827 LINCOLN AVENUE CAMDEN NJ 08105 SUSPENSION 4/29/2003

MARRAZZO-TALLIA, RPH 1/3/1955 406 HARDING ROAD FAIRHAVEN NJ 07704 SUSPENSION 10/19/2006MARSON-FRANCIS, JAVON

CHHA 9/16/1993 7810 CORBETT ROAD PENNSAUKEN NJ 08109 DISQUALIFICATION 4/18/2017

MARTIN, ANDRE E. COUNSE 12/6/1972 127 N. DERBY AVENUE VENTNOR NJ 08406 DEBARMENT 5/24/1999MARTIN, BENNIE M. COUNSE 12/19/1964 476 CLIFTON AVENUE CLIFTON NJ 07011 SUSPENSION 5/15/2003MARTIN, CHERYL LEE a.k.a. JOHNSTON, CHERYL ANDERSON

RN 10/7/1961 600 PACIFIC AVENUE, APT B203

ATLANTIC CITY NJ 08401 DISQUALIFICATION 11/18/2021 PERMANENT

MARTIN, ELLIOTT DPM 9/19/1936 5 HOLLIS ROAD EAST BRUNSWICK NJ 08816 DISQUALIFICATION 4/22/1991 DECEASEDMARTIN, MARGARET LPN 1/15/1959 207 HEGGEN AVENUE EGG HARBOR NJ 08234 DISQUALIFICATION 9/8/2017 PERMANENTMARTIN, PATRICK 11/17/1959 51 HENRY STREET SUCCASUNNA NJ 07876 DISQUALIFICATION 11/20/2015MARTIN, SUSAN C. LPN/RN 7/8/1961 3421 BRIGHTON STREET PHILADELPHIA PA 19149 SUSPENSION 9/20/2005MARTINEZ, CINTYA CHHA 8/17/1982 61 CONCORD STREET, APT. JERSEY CITY NJ 07306 DISQUALIFICATION 2/20/2017MARTINEZ, ELIEZER COUNSE

LOR11/25/1947 215 SOUTH BURLINGTON

ROADBRIDGETON NJ 08302 SUSPENSION 2/20/2006



68






EXPIRATION DATE

MARTINEZ, NATASHA CHHA 11/6/1991 87 N. 7TH STREET, APT. 1 PATERSON NJ 07522 DISQUALIFICATION 9/26/2018MARTINEZ, RENATO F. MD 9/1/1948 199 BROAD STREET, SUITE 1- BLOOMFIELD NJ 07003 SUSPENSION 8/5/1997MARTINEZ, SUZETTE CHHA 12/26/1966 52 FOREST GLEN DRIVE HIGHLAND PARK NJ 08904 DISQUALIFICATION 7/31/2017MARTINIQUE, BURTON OD 3/27/1935 1942370945 2 SHEFFIELD DRIVE WILLINGBORO NJ 08046 DEBARMENT 4/18/2016MARTIROSOV, ALEKSANDR

DO 8/19/1963 1700931185 1084 BRIAR WAY FORT LEE NJ 07024 DISQUALIFICATION 11/20/2017 5/30/2018

MARTORANO, JOSEPH RPH 8/13/1935 1248 STANWOOD STREET PHILADELPHIA PA 19100 DISQUALIFICATION 6/1/1993MARUCCI, DONATO MD 11/14/1955 14 FRANKLIN STREET BELLEVILLE NJ 07109 DISQUALIFICATION 9/28/1999MARURI, NAGESWARA REDDY

RPH 3/20/1952 1083932495 8 REDWOOD AVENUE WEST ORANGE NJ 07052 DISQUALIFICATION 2/11/2016

MASCOLO, JOSEPHINE RN 6/4/1949 1814 KENNEDY BOULEVARD UNION CITY NJ 07087 DEBARMENT 4/7/2004MASHALI, FATHALLA MD 11/19/1954 1386609907 FMC DEVENS #96065-038, AYER MA 01432 DISQUALIFICATION 8/20/2018MASI, JAMES COUNSE 10/4/1947 1518046226 631 OCEAN AVENUE, BRADLEY BEACH NJ 07720 DEBARMENT 2/20/2013MASON, JAMES I. 8/7/1926 702 SUNSHINE LAKES DRIVE VOORHEES NJ 08043 SUSPENSION 2/23/2000

MASON, SYDELLE 9/19/1942 702 SUNSHINE LAKES DRIVE VOORHEES NJ 08043 SUSPENSION 2/23/2000

MASOOD, MARUK 3/14/1968 1 CHESTERFIELD DRIVE WARREN NJ 07059 DISQUALIFICATION 11/20/2012MASOOD, YOUSUF MD 4/19/1964 1235343138 PO BOX 8000 BRADFORD PA 16701 DISQUALIFICATION 11/20/2012MASRI, NASSER M. 2/1/1966 360 GETTY AVENUE PATERSON NJ 07503 SUSPENSION 10/19/2000 2/15/2019MASSARO, DONNA M. AUDIOL 11/24/1959 205 RIVA DRIVE, APT. 24 HACKETTSTOWN NJ 07840 SUSPENSION 11/20/2008MASTRANGELO, MARTHA LPN 12 NORTH 28TH AVENUE LONGPORT NJ 08403 DISQUALIFICATION 6/1/1993

MASTRIA, ERNEST PSYCH 12/6/1947 213 9TH AVENUE BELMAR NJ 07719 DISQUALIFICATION 8/18/2011MASTROKOSTAS, ANTHANASIOS

RPH 1/29/1973 1861769481 11 EQUINOX LANE FREEHOLD NJ 07728 DISQUALIFICATION 10/15/2009 2/15/2019

MATALON, VIVIENNE MD 4/19/1956 1396858635 1 NORTH SYRACUSE DRIVE CHERRY HILL NJ 08034 DISQUALIFICATION 12/19/2016

MATALON, VIVIENNE MD 4/19/1956 1396858635 1 NORTH SYRACUSE DRIVE CHERRY HILL NJ 08034 DEBARMENT 10/31/2016MATHEW, REX MD 8/27/1975 1336164862 2301 SOUTH BROAD STREET PHILADELPHIA PA 19148 DISQUALIFICATION 1/2/2017MATHEW, REX MD 8/27/1975 1336164862 17608 PRINCE EDWARD OLNEY MD 20832 DISQUALIFICATION 4/4/2018MATRISS, JOSEPH P. DDS 7/3/1923 1700013554 337 HENRY STREET HASBROUCK HEIGHTS NJ 07604 SUSPENSION 9/18/2003MATRISS, JOSEPH P. DDS 7/3/1923 1700013554 337 HENRY STREET HASBROUCK HEIGHTS NJ 07604 DEBARMENT 10/9/2007



69






EXPIRATION DATE

MATTERN, JILL MD 3/12/1961 1669514253 20 WILSON TERRACE, APT. 1 STATEN ISLAND NY 10304 DEBARMENT 11/29/2015MATTHEWS, BHA'SHEER CHHA 6/24/1994 16 HEMLOCK WALK CAMDEN NJ 08104 DISQUALIFICATION 4/18/2017MATURA, DENISE RN 9/27/1969 1001 LINDEN AVENUE BRICK NJ 08723 SUSPENSION 10/26/1999 7/20/2012MATURA, WILLIAM DC 11/7/1943 PO BOX 7000 FORT DIX NJ 08640 SUSPENSION 12/20/2006MATZ, RODNEY S. MD 2/6/1942 43 MACDONALD DRIVE WAYNE NJ 07470 DISQUALIFICATION 12/29/1995MAUGLE, BARBARA DPM 7/30/1963 800 HILLSIDE AVENUE WESTFIELD NJ 08901 DISQUALIFICATION 1/10/2001MAUIRI, SANDY LPN 6/20/1958 34 FRANKLIN PLACE TOTOWA NJ 07512 SUSPENSION 6/20/2005MAWHINNEY-BRIGNOLA, RN 3/31/1949 PO BOX 468 BLAIRSTOWN NJ 07825 SUSPENSION 6/20/2001MAXVITAT, KATHLEEN E. PHARM 5/8/1986 200 W. MERCHANTS STREET AUDUBON NJ 08106 SUSPENSION 4/20/2011MAXYMIV, NICOLAI 3/13/1971 3 PARKWOOD DRIVE SOUTH AMBOY NJ 08879 DISQUALIFICATION 7/10/2003MAYER, FREDERICK G. DC 6/17/1953 1811082894 610 WOODLAND AVENUE AVON BY THE SEA NJ 07717 DISQUALIFICATION 8/20/2000 9/21/2011MAYS, CYNTRICE CHHA 7/11/1984 98 OAK STREET CLEMENTON NJ 08021 DISQUALIFICATION 9/19/2017MAYS, ROBERT E. 6/26/1977 6133 HANLON STREET CAPITAL HEIGHTS MD 20743 DISQUALIFICATION 10/31/2017MAZUR, BONNIE DMD 1/21/1961 210 E. SEAVIEW AVENUE LINWOOD NJ 08221 SUSPENSION 1/27/1998MAZZACCOS PHARMACY INC.

427 PROSPECT STREET LONG BRANCH NJ DISQUALIFICATION 7/27/1983

MCAFEE, JORDAN CHHA 7/24/1987 13 FAIRWAY COURT MARLTON NJ 08053 DISQUALIFICATION 7/20/2017MCAULAY-LEVESQUE, LPN 12/9/1954 141 BRUNSWICK AVENUE BLOOMSBURY NJ 08804 DISQUALIFICATION 4/27/2019 PERMANENTMCCABE, LAUREN AKA RN 4/10/1982 9 FIELDCREST WAY HAZLET NJ 07730 DISQUALIFICATION 12/30/2019MCCABE, VALERIE A. LPN 1/21/1964 830 CHESTNUT STREET KEARNY NJ 07032 SUSPENSION 9/20/2004MCCAFFERTY, ASHLEY RN 8/2/1991 245 ATLANTIC AVENUE, APT. LONG BRANCH NJ 07740 DISQUALIFICATION 1/29/2019MCCAGG, CAROLINE MD 1/4/1940 1346261849 1415 MARTINE AVENUE PLAINFIELD NJ 07060 DISQUALIFICATION 4/18/2019 PERMANENTMCCALL, ELDORA CHHA 1/7/1965 OLD CRANBURY ROAD CRANBURY NJ 08512 SUSPENSION 9/20/2007MCCANN, DAVID 5/14/1968 16 LAFAYETTE PLACE LYNDHURST NJ 07071 DISQUALIFICATION 10/3/2019MCCARVILLE, MICHAEL MD 8/21/1956 1871666321 1020 IRVING AVENUE ENDICOTT NY 13760 DISQUALIFICATION 11/20/2015MCCASKILL, CAMMY 11/3/1970 6518 BOBOLINK PLACE PHILADELPHIA PA 19142 DISQUALIFICATION 11/20/2015MCCASKILL, JACQUELINE CHHA 6/20/1963 34 36 12TH AVENUE PATERSON NJ 07524 DISQUALIFICATION 10/15/2004MCCOLGAN, PETER DMD 3/30/1946 RR 1, PO BOX 29 TANNERSVILLE PA 18372 SUSPENSION 6/19/2001MCCOLGAN, PETER DMD 3/30/1946 35 OLD WOLFE ROAD BUDD LAKE NJ 07828 DEBARMENT 5/13/1999MCCREA, NIOME CHHA 1/11/1989 63 VILLAGE DRIVE BARNEGAT NJ 08005 DISQUALIFICATION 9/26/2017MCDANIELS, HOLLY RN 1/4/1988 111 COUNTRYSIDE DRIVE MYRTLE BEACH SC 29579 DISQUALIFICATION 6/28/2017MCDONALD, JOSEPH MD 8/17/1933 2052 MORRIS AVENUE UNION NJ 07083 DEBARMENT 9/21/1999MCDONALD, KEITH THERAPI 7/7/1954 2220 MEADOW LANE, SECAUCUS NJ 07094 DISQUALIFICATION 2/20/2001MCDONALD, RHONDA RN 8/20/1970 962 GROVE STREET IRVINGTON NJ 07111 SUSPENSION 1/18/2007



70






EXPIRATION DATE

MCDONALD-HASWELL, 6/10/1955 52 ELM STREET MONTCLAIR NJ 07042 SUSPENSION 4/18/2002MCDOWELL, SHASHAWN CHHA 5/25/1994 25 WILLIAM STREET, 2ND FL LITTLE FALLS NJ 07424 DEBARMENT 12/6/2017

MCELROY, DONALD J. DDS 9/14/1923 14 RESERVOIR AVENUE DOVER NJ 07801 DISQUALIFICATION 2/20/1983MCFADDEN, TIKEYA CHHA 2/13/1991 526 RAND STREET CAMDEN NJ 08105 DISQUALIFICATION 2/8/2017MCGAVIN, CAMERON LINDSAY

PSYCH 11/9/1969 1760408041 417 BOYD STREET TURTLE CREEK PA 15145 DISQUALIFICATION 3/27/2015

MCGEE, ELIZABETH RN 8/25/1957 51 VAN DUYNE AVENUE WAYNE NJ 07470 SUSPENSION 2/20/2002MCGEE, JOHN MD 5/8/1958 1811991284 1160 KENNEDY BOULEVARD BAYONNE NJ 07002 DEBARMENT 9/6/2016MCGILL, WINSTON MD 4/4/1947 1093810749 258 CENTRAL AVENUE ORANGE NJ 07050 DEBARMENT 10/16/2014MCGINNIS, GEORGE J. 119 ADELINE STREET TRENTON NJ 08611 DISQUALIFICATION 10/16/1986MCGINTY, JAMIE RN 5/9/1978 251 DEVON ROAD TOWNSHIP OF

WASHINGTONNJ 07676 DISQUALIFICATION 7/22/2017

MCGLONE, CARLA RN 6/21/1960 10 MILLS BROOK LANE SHAMONG NJ 08088 DISQUALIFICATION 3/11/2019MCGLOSTER, CARL L. DDS 12/5/1965 1962517839 90 TIFFANY BOULEVARD NEWARK NJ 07104 DISQUALIFICATION 5/20/2007MCGRATH, HELEN J. RN 6/20/1950 6 BLAIR ROAD KENDALL PARK NJ 08824 SUSPENSION 10/20/2005MCGRATH, ROBERT CHRISTOPHER

DC 6/22/1969 1417989864 FCI FORT DIX, PO BOX 2000 JOINT BASE MDL NJ 08640 DISQUALIFICATION 9/20/2018

MCGRATH, ROBERT CLAUDE

DO 10/1/1951 1912110636 CANAAN USP, PO BOX 300 WAYMART PA 17837 DISQUALIFICATION 2/5/2019

MCGRATH, ROBERT CLAUDE

DO 10/1/1951 1912110636 3411 KENWOOD COURT MAYS LANDING NJ 08330 DISQUALIFICATION 10/13/2020 PERMANENT

MCINTYRE, JOHN G. DDS 10/8/1957 1487740718 1301 PENN AVENUE WYOMISSING PA 19610 DEBARMENT 6/22/2002 12/2/2011MCKEAN JR., JOSEPH MD 7/14/1941 2601 MEADOW VIEW ROAD EDMOND OK 73013 DISQUALIFICATION 5/15/2000MCKEITHAN, SHAVONNE LPN 1/31/1972 259 SECOND STREET HACKENSACK NJ 07601 DISQUALIFICATION 6/5/2017

MCKNIGHT, BOBBY 3/14/1986 4543 NORTH GRATZ STREET PHILADELPHIA PA 19140 DISQUALIFICATION 11/20/2015

MCLAUGHLIN, KELLY M. LPN 12/27/1971 SANDYBROOK ROAD MANALAPAN NJ 07726 SUSPENSION 8/20/2008MCLAY, WILLIAM MD 4/28/1944 1033133970/1

6595854381150 GEORGIA AVENUE CAPE MAY

COURTHOUSENJ 08210 DISQUALIFICATION 7/16/2018 PERMANENT

MCLEAN, EDWARD 506 MONTICELLO COURT MARLTON NJ 08053 SUSPENSION 7/18/2002MCLEISH, FREDERICK RPH 7/11/1962 1447461504 5 WINDSOR DRIVE EGG HARBOR NJ 08234 DISQUALIFICATION 7/19/2017 PERMANENT



71






EXPIRATION DATE

MCLEOD, MEGHAN AKA WHITE, MEGHAN

CHHA 11/23/1992 271 SERPENTINE DRIVE BAYVILLE NJ 08721 DISQUALIFICATION 5/8/2019

MCMAHON, THOMAS MD 11/2/1944 1952309742 121 WARWICK ROAD HADDONFIELD NJ 08033 DEBARMENT 2/15/2016 PERMANENTMCMURTRY-BURRELL, DIANE

RPH 10/6/1965 1609015015 MDC BROOKLYN, PO BOX 329002

BROOKLYN NY 11232 DISQUALIFICATION 5/20/2015

MCMURTRY-BURRELL, DIANE

RPH 10/6/1965 1609015015 MDC BROOKLYN, PO BOX 329002

BROOKLYN NY 11232 DISQUALIFICATION 11/20/2015

MCPHERSON, KIMBERLY CHHA 5/14/1987 110 THOMAS AVENUE LAWNSIDE NJ 08045 DISQUALIFICATION 2/8/2017MCPHERSON, M. LEEANNE

RPH 12/27/1971 269 HAMPTON STREET BRIDGETON NJ 08302 SUSPENSION 3/7/2008

MCQUEEN, BRITTANY CHHA 10/18/1987 807 N. INDIANA AVENUE ATLANTIC CITY NJ 08401 DISQUALIFICATION 1/23/2018MCRAE, CHANEL CNA 4/27/1978 448 RAILROAD BOULEVARD RICHLAND NJ 08350 DISQUALIFICATION 2/23/2006

MEDICAL CLINICAL LABORATORIES

373 LIVINGSTON AVENUE NEW BRUNSWICK NJ 08901 DISQUALIFICATION 7/29/1999

MEDIPATH EXPRESS 666 PLAINSBORO ROAD PLAINSBORO NJ 08536 DISQUALIFICATION 1/14/2005MEDISCOPE DIAGNOSTIC 1250 PARK AVENUE PLAINFIELD NJ 07060 SUSPENSION 11/16/1998MEDVEDIK, YELENA 10/15/1972 2 HICKORY HILLS COURT HOLMDEL NJ 07733 DISQUALIFICATION 10/3/2013MEDVEDOVSKY, ANDREW DC 8/9/1982 1649431594 11 AUTUMN DRIVE MOORESTOWN NJ 08057 DISQUALIFICATION 8/4/2020MEEHAN KIERMIER, DMD 11/18/1969 1245445931 1116 BENNETT DRIVE WOODBURY NJ 08096 DISQUALIFICATION 12/26/2018 4/9/2019MEHTA, MAHESH MD 9/17/1952 1396859385 157 RUTGERS PLACE NUTLEY NJ 07110 DISQUALIFICATION 4/2/2020MEISHER, VLAD A. PSYCH 9/23/1939 HILLSIDE TERRACE FAIR LAWN NJ 07410 DISQUALIFICATION 8/10/2007MEISHER, VLAD A. PSYCH 9/23/1939 15-07-PLAZA ROAD, APT. A FAIRLAWN NJ 07410 DISQUALIFICATION 8/1/2009MELENDEZ, JUANITA COUNSE 6/16/1938 NORTH 35TH STREET CAMDEN NJ 08105 SUSPENSION 4/29/2003MELENDEZ, LIZZADY CHHA 12/2/1984 602 SOUTH 4TH STREET CAMDEN NJ 08103 DISQUALIFICATION 1/26/2018MELKER, NEIL L. DDS 11/7/1956 1053443705 219 VALLEY ROAD PRINCETON NJ 08540 DISQUALIFICATION 1/23/2009MELTZER, SCOTT M. DMD 1/4/1964 1366561425 70 WELLESLEY WAY FREEHOLD NJ 07728 DISQUALIFICATION 4/17/2014 5/21/2020MELTZER, SCOTT M. DMD 1/4/1964 1366561425 70 WELLESLEY WAY FREEHOLD NJ 07728 DEBARMENT 5/3/2013 5/21/2020MEMBER, BERNARD J. MD 1/29/1948 12335 S. ANNA DRIVE ROCKVILLE MD 23146 SUSPENSION 5/20/2004MENDEL, RICHARD 6/1/1961 1306939202 701 SO. HOWARD AVENUE, TAMPA FL 33606 DISQUALIFICATION 12/29/2015MENDEZ, EDELFONSO R. DO 11/16/1964 SMITH AVENUE NORTH BERGEN NJ 07047 DISQUALIFICATION 3/20/2008MENDEZ, NORMA CHHA 2/6/1967 60 BALDWIN STREET, #2 NEW BRUNSWICK NJ 08901 DISQUALIFICATION 2/20/2017



72






EXPIRATION DATE

MENSAH-NARH, STEVEN RPH 5/29/1962 WEDGEWOOD DRIVE NORTH BRUNSWICK NJ 08902 DISQUALIFICATION 2/20/2007

MEO, JOHN RPH 8/11/1954 1427086818 149 BOWNE ROAD WAYSIDE NJ 07712 DISQUALIFICATION 5/27/2009MERVIL, DARLEIN CHHA 9/20/1988 122 ROSSITER AVENUE PATERSON NJ 07502 DEBARMENT 5/31/2018MESA, NELSON PCA 3/28/1944 964 GROVE STREET, APT. A ELIZABETH NJ 07202 DISQUALIFICATION 4/17/2017MESSICK, PAULA LPN 1/28/1957 105 SUMMIT AVENUE EWING NJ 08628 DISQUALIFICATION 6/18/2009MESSO, RALPH MD 9/3/1961 1184798621/1 2 RICHMONDE COURT COLTS NECK NJ 07722 DEBARMENT 5/28/2015MESSO, RALPH MD 9/3/1961 1184798621/1

255309175FCI FORT DIX, PO BOX 2000 JOINT BASE MDL NJ 07722 DISQUALIFICATION 12/26/2018

METTEAUX, IYANNAH CHHA 3/24/1989 46 N. ARLINGTON AVENUE EAST ORANGE NJ 07017 DISQUALIFICATION 2/8/2017METZ, DANIEL 7/11/1980 FCI OTISVILLE #66799-050 OTISVILLE NY 10963 DISQUALIFICATION 7/20/2015MEYER, CYNTHIA RN 12/12/1963 8200 KENNEDY BOULEVARD NORTH BERGEN NJ 07047 DISQUALIFICATION 2/20/2018MEYER, GLORIA KINGS HIGHWAY MIDDLETOWN NJ 07748 DISQUALIFICATION 6/1/1993MEYER, JOSEPH KINGS HIGHWAY MIDDLETOWN NJ 07748 DISQUALIFICATION 6/1/1993MEYERLE, GISELA LPN 8/4/1966 1356538169 705 SUNFLOWER AVENUE, LANGHORNE PA 19047 DISQUALIFICATION 2/28/2018MEYERLE, GISELA LPN 8/4/1966 1356538169 705 SUNFLOWER AVENUE, LANGHORNE PA 19047 DISQUALIFICATION 5/25/2019MEZERENEZ, MARIA CHHA 7/8/1986 33 ASPEN PLACE PASSAIC NJ 07055 DISQUALIFICATION 3/6/2018MGBEME, FESTUS RPH 8/22/1954 882 BROAD STREET NEWARK NJ 07114 DISQUALIFICATION 3/8/2001MICHAIL, MEDHAT DDS 10/17/1959 848 BERGEN AVENUE JERSEY CITY NJ 07306 SUSPENSION 4/29/1998MIKHAIL, PETER RPH 11/11/1978 48 FALLON AVENUE ELMONT NY 11003 DISQUALIFICATION 11/18/2004MIKOS, KRISTEN RN 6/8/1979 2111 PRINCETON PIKE PHILADELPHIA PA 19149 DISQUALIFICATION 5/2/2017MIKSIS, MARY E. RN 12/5/1958 126 WINSTEAD DRIVE WESTAMPTON NJ 08060 DISQUALIFICATION 2/17/2004MIL, PAUL 11/2/1949 USP LEWISBURG, PO BOX LEWISBURG PA 17837 DISQUALIFICATION 2/9/2017MILAROLA CORPORATION 57 BROADWAY NEWARK NJ 07014 DISQUALIFICATIONMILLER, DEBBIE L. DO 6/6/1949 1750561866 94 EAST WATER STREET TOMS RIVER NJ 08753 DEBARMENT 4/26/2002 DECEASEDMILLER, DEIDRE T. 12/23/1962 20 PERENNIAL LANE WILLINGBORO NJ 08046 DISQUALIFICATION 7/19/2001MILLER, DEIDRE T. 12/23/1962 92 RITTENHOUSE DRIVE WILLINGBORO NJ 08046 DISQUALIFICATION 3/29/2000MILLER, JOSEPH M. DO 4/19/1971 1255307856 9 VICTORIA CIRCLE JACKSON NJ 08527 DISQUALIFICATION 8/20/2015MILLER, JUSTIN PSYCH 2/1/1981 1952594921 616 DALE COURT WEST RIVERVALE NJ 07675 DISQUALIFICATION 1/2/2017 PERMANENTMILLER, RANDALL DO 1/3/1952 1740342575 1015 VAN HOUTEN AVENUE CLIFTON NJ 07013 DISQUALIFICATION 1/1/2001 4/6/2017MILLER, ROY C. 703 WEST SHORE TRAIL LAKE MOHAWK NJ 07871 DISQUALIFICATION 6/1/1993MILLER, SANDRENE A. MD 11/19/1948 1912192527 50 UNION AVENUE, SUITE IRVINGTON NJ 07111 SUSPENSION 2/25/1998MILLER, SANDRENE A. MD 11/19/1948 1912192527 202 ELMWYND DRIVE ORANGE NJ 07050 SUSPENSION 7/22/1999MILLET, CYNTHIA CHHA 6/10/1993 104 ROUTE 46 EAST ELMWOOD PARK NJ 07407 DEBARMENT 8/24/2017



73






EXPIRATION DATE

MILMAN, BORIS 3/3/1951 655 AMBOY AVENUE WOODBRIDGE NJ 07095 DISQUALIFICATION 9/11/2001MILORADOVICH, VADIM MD 5/11/1944 58 MERCER AVENUE HARTSDALE NY 10530 DISQUALIFICATION 11/20/2013MILVIHILL, CHELSIE CHHA 11/5/1990 501 MAPLE STREET LAKEHURST NJ 08733 DEBARMENT 12/18/2017MIMS, CAROLE 9/30/1946 1058 WILLOW STREET NORRISTOWN PA 19401 DISQUALIFICATION 11/20/2015MINATEE, SHERAI LPN 1/2/1980 509 WARWICK ROAD LAWNSIDE NJ 08045 DISQUALIFICATION 3/15/2018MINNOW, MARY CHHA 7/10/1958 9 WINDINGWOOD DRIVE SAYREVILLE NJ 08872 DISQUALIFICATION 7/25/2001MIRAGLIA, ROBERT LCSW 10/1/1954 254 VOSE AVENUE SOUTH ORANGE NJ 07079 SUSPENSION 5/9/2002MIRANDA, MEREDITH RPH 1/2/1983 1053740993 3204 BLUE MOUNTAIN LANE NAZARETH PA 18064 DISQUALIFICATION 10/25/2016MIRILASHVILI, MOSHE B. MD 6/15/1948 1427081223 PO BOX 350146 BROOKLYN NY 11235 DISQUALIFICATION 11/17/1999MIRZA, MUHAMMED MD 3/10/1942 1467450262 145 GARRISON AVENUE JERSEY CITY NJ 07306 DEBARMENT 5/8/2019 11/18/2019MISHRA, ARUNA MD 8/10/1938 63 WEST BROADWAY SALEM NJ 08079 DISQUALIFICATION 2/4/1997MISHRA, ARUNA MD 8/10/1938 317B AUBURN ROAD PILESGROVE NJ 08098 DEBARMENT 1/3/2000MITRA, RANAJIT MD 1/12/1952 1417096942 2366 ST. GEORGES AVENUE RAHWAY NJ 07065 DEBARMENT 10/12/2014MITRA, RANAJIT MD 1/12/1952 1417096942 2366 ST. GEORGES AVENUE RAHWAY NJ 07065 DISQUALIFICATION 7/20/2015MITRESKI, IGOR MD 6/20/1978 1629305255 10 IVY LANE WALLINGTON NJ 07057 DISQUALIFICATION 3/26/2015MITSUI, MASAO MD 6/19/1939 9 BRIARWOOD ROAD JERSEY CITY NJ 07305 SUSPENSION 12/20/2001MOCKOVIAK, PATRICIA LPN 10/5/1954 5 BEECH STREET EDISON NJ 08817 SUSPENSION 2/19/2004MODICA, JOSEPH CHHA 6/4/1979 82 JEFFERSON STREET SOUTH BOUND

BROOKNJ 08880 DISQUALIFICATION 1/31/2017

MOHAMED, ASHLI CHHA 11/29/1990 10-4 FOUNTAIN AVENUE TRENTON NJ 08618 DISQUALIFICATION 1/31/2017 11/5/2018MOHAMED, ASHLI CHHA 11/29/1990 10-4 FOUNTAIN AVENUE TRENTON NJ 08618 DEBARMENT 11/6/2018 MOHAMED, HASHIM H. 5/13/1965 PO BOX 8332 JERSEY CITY NJ 07308 DISQUALIFICATION 4/12/1994MOHAMMAD, OMAR RPH 11/3/1977 1053580068 15 GRIST MILL LANE UPPER SADDLE RIVER NJ 07458 DISQUALIFICATION 1/20/2012 5/17/2018

MOHAMMAD, OMAR RPH 11/3/1977 1053580068 15 GRIST MILL LANE UPPER SADDLE RIVER NJ 07458 DISQUALIFICATION 9/20/2012 5/17/2018

MOHAPELOA, GUGU MD 8/31/1947 1306952636 6 CORNELL ROAD PARLIN NJ 08859 DISQUALIFICATION 1/3/2019 PERMANENTMOJICA, MARIA CHHA 11/27/1989 108 BEECH STREET PATERSON NJ 07501 DISQUALIFICATION 1/31/2017MOLDAVER, INNA 1/19/1948 32 BEECHWOOD AVENUE EDISON NJ 08837 DEBARMENT 2/17/2016MOLINA, DANIEL RPH 8/29/1961 320 EAST 42ND STREET, APT. NEW YORK NY 10017 DISQUALIFICATION 6/28/2017MONACO, STEVEN 4/5/1982 21 JAMIE DRIVE SEWELL NJ 08080 SUSPENSION 4/9/2021MONDELO, BARBARA AKA TAYLOR, BARBARA

12/14/1965 363 KENTWOOD BOULEVARD BRICK NJ 08724 DEBARMENT 10/24/2008



74






EXPIRATION DATE

MONFORTO, CHRISTINE RN 7/6/1984 2620 HAMILTON DRIVE VOORHEES NJ 08043 DISQUALIFICATION 12/29/2015

MONICA, JULIANNE H. DC 4/12/1957 1235372608 509 ESSEX AVENUE SPRING LAKE NJ 07762 SUSPENSION 2/20/2002MONK, SHENISE LPN 8/6/1990 416 CHAMBERS AVENUE CAMDEN NJ 08103 DISQUALIFICATION 10/24/2018MONSUL, ROBERT W. MD 6/1/1931 301 NORTH MAIN STREET MANVILLE NJ 08835 DISQUALIFICATION 5/10/1990MONTE, LYDA MD 9/27/1940 1114068236 430 W. BROWNING ROAD, BELLMAWR NJ 08031 DISQUALIFICATION 12/4/2018 PERMANENTMONTE, LYDA MD 9/27/1940 1114068236 430 W. BROWNING ROAD, BELLMAWR NJ 08031 DISQUALIFICATION 10/3/2019 MONTES, NANCY CHHA 5/21/1966 17-20 WELL DRIVE FAIR LAWN NJ 07410 DISQUALIFICATION 8/1/2017MONTORIO, JENNIFER CHHA 2/11/1973 110 OUTER DRIVE DINGMANS FERRY PA 18328 DISQUALIFICATION 9/11/2019MOON, RASHIKA RN 6/17/1970 2 JASON CIRCLE PENNS GROVE NJ 08069 DISQUALIFICATION 6/28/2017MOONEY, MARY MELISSA LPN 5/24/1973 777 CHERRY TREE ROAD ASTON PA 19014 DISQUALIFICATION 4/23/2007MOOR, JEAN RN 1/19/1956 100 COLONIAL WAY ALIQUIPPA PA 15001 DISQUALIFICATION 11/20/2015MOORE, BRITTANY CHHA 2/28/1994 141 BORDEN AVENUE ASBURY PARK NJ 07712 DISQUALIFICATION 7/14/2017MOORE, HANEEFAH CHHA 7/27/1983 48 MONTROSE TERRACE IRVINGTON NJ 07111 DISQUALIFICATION 10/3/2018MOORE, JANE A. RN 2/27/1962 235 KINGS ROAD MADISON NJ 07940 SUSPENSION 5/19/2005MOORE, JONATHAN R. MD 4/23/1917 19 N. PEARL STREET BRIDGETON NJ 08302 DISQUALIFICATION 8/19/1997MOORE, LILLIE, R. 8/31/1961 353 S. CENTER STREET, APT.

19ORANGE NJ 07050 SUSPENSION 10/20/2002

MOORE, LYNDA A. LPN 1/13/1968 10719 JUREL COURT W. APT. LAKEVILLE MN 55044 SUSPENSION 1/19/2005MOORE, MONICA AKA 2/1/1969 27 FIRETOWER ROAD BUDD LAKE NJ 07828 DEBARMENT 9/15/2017MOORJANI, KAMAL RPH 7/3/1970 217 VAN BUREN STREET LYNDHURST NJ 07071 DISQUALIFICATION 6/1/2010 8/26/2016MOORMANN, BARBARA CHHA 11/3/1947 2467 BREATHSTONE DRIVE POWELL OH 46065 DISQUALIFICATION 2/20/2017MORALES SR., OSVALDO 8/26/1948 78 W. 180TH STREET, 2ND FL BRONX NY 10453 SUSPENSION 4/13/2008MORALES SR., OSVALDO 8/26/1948 78 W. 180TH STREET BRONX NY 10453 DISQUALIFICATION 9/16/2011MORALES, ARLENE 3/18/1956 254 NORTH 7TH STREET NEWARK NJ 07107 SUSPENSION 9/19/2002MORALES, CHRISTINO 8/22/1964 328 MARKET STREET CAMDEN NJ 08102 SUSPENSION 10/5/2000MORALES, CHRISTINO 8/22/1964 PO BOX 26883 PHILADELPHIA PA 19134 SUSPENSION 7/2/2003MORALES, FERNANDO CNA 2/18/1981 346 S. MAIN STREET PHILLIPSBURG NJ 08865 SUSPENSION 12/21/2004MORALES, JAMES MD 3/8/1970 1386649507 16 WOODVIEW DRIVE HOWELL NJ 07731 DEBARMENT 4/11/2016MORALES, JAMES MD 3/8/1970 1386649507 2319 CRYSTAL MILE COURT TOMS RIVER NJ 08755 SUSPENSION 1/11/2016 4/11/2016

MORALES, JAMES MD 3/8/1970 1386649507 16 WOODVIEW DRIVE HOWELL NJ 07731 DISQUALIFICATION 11/30/2017MORALES, JUSTINA CHHA 4/7/1991 62 HIGH STREET WOODBURY NJ 08096 DISQUALIFICATION 2/8/2017



75






EXPIRATION DATE

MOREL, MARIA CHHA 5/25/1974 735 TWENTY SECOND STREET PATERSON NJ 07504 DISQUALIFICATION 7/14/2017MORELAND, CHARLOTTE CNA 1/21/1965 121 PROSPECT VILLAGE, APT. TRENTON NJ 08618 DISQUALIFICATION 4/29/2008MORELAND, CHARLOTTE CNA 1/21/1965 121 PROPECT VILLAGE, APT. TRENTON NJ 08618 SUSPENSION 9/20/2008MORELLI, TIMOTHY J. RPH 10/28/1955 801 BUTLER PIKE MERCER PA 16137 SUSPENSION 5/19/2005MORELOS, LISA A. RN 3/14/1965 162 SHENANDOAH

BOULEVARDTOMS RIVER NJ 08753 SUSPENSION 6/19/2003

MORENO, BARTOLO COUNSELOR

6/27/1959 2221 38TH STREET PENNSAUKEN NJ 08110 SUSPENSION 4/29/2003

MORERA, JESSICA CHHA 12/31/1981 116 DALTON STREET ROSELLE PARK NJ 07204 DISQUALIFICATION 2/8/2017MORGANSTEIN, HENRY DO 9/14/1939 1689730343 774 CARTERET COURT MOUNT LAUREL NJ 08054 DISQUALIFICATION 11/23/2010MORGANSTEIN, HIRAM N. OD 9/26/1918 5618 BERGENLINE AVENUE WEST NEW YORK NJ 07093 DEBARMENT 2/22/2001

MORIARTY, JACK 4/4/1952 312 GRANDE RIVER TOMS RIVER NJ 08755 SUSPENSION 4/8/1999MORRIS, CANDICE CHHA 6/26/1980 154 NORTH SPRING STREET, BLOOMFIELD NJ 07003 DISQUALIFICATION 6/22/2018 PERMANENTMORRIS, CHRISTINE CHHA 12/3/1984 323 KAIGHN AVENUE CAMDEN NJ 08103 DISQUALIFICATION 5/16/2018MORRISON, JAMES C. MD 2/13/1927 RADIO ROAD AT EAST BOAT TUCKERTON NJ 07087 DISQUALIFICATION 6/1/1993MORTON, MARION RPH 3/3/1966 2321 SPRUILL AVENUE, APT. NORTH CHARLESTON SC 29405 DEBARMENT 2/6/2012MOSHKOVITCH, VASIL MD 4/22/1955 1326116419 41 NAUTILUS DRIVE MANAHAWKIN NJ 08050 DISQUALIFICATION 11/22/2016 PERMANENTMOSHKOVITCH, VASIL MD 4/22/1955 1326116419 41 NAUTILUS DRIVE MANAHAWKIN NJ 08050 DISQUALIFICATION 3/3/2017 PERMANENTMOSKOWITZ, MYRON DPM 1/21/1942 705 RIDGE DRIVE UNION NJ 07083 SUSPENSION 11/20/2006MOSS, ALBERT H. MD 10/20/1940 28 BARTLE ROAD SOMERSET NJ 08873 SUSPENSION 5/19/2005MOSS, ROBERT H. DPM 5/15/1968 1881716348 244 N. MAIN STREET MULLICA HILL NJ 08062 DEBARMENT 11/2/2011MOSS, ROBERT H. DPM 5/15/1968 1881716348 FCI OTISVILLE, PO BOX 1000 OTISVILLE NY 10963 DISQUALIFICATION 11/20/2015MOSS, ROBERT H. DPM 5/15/1968 1881716348 244 NORTH MAIN STREET MULLICA HILL NJ 08062 DISQUALIFICATION 2/20/2013MOSSAVI, AHMAD MD 11/8/1944 1629046248 7 MALKE DRIVE OCEAN NJ 07712 DEBARMENT 2/23/2012MOTA, KAESHA CHHA 1/2/1994 433 N. 7TH STREET CAMDEN NJ 08102 DISQUALIFICATION 7/14/2017MOTT, TARA RN 2/28/1982 3557 SHARON ROAD WEST MIDDLESEX PA 16159 DISQUALIFICATION 11/20/2015MOULDER, DARIA PHARM

TECH1/16/1962 2715 BAYSHORE ROAD VILLAS NJ 08251 DISQUALIFICATION 4/20/2010

MOUNT LAUREL CENTER 1851669287 3718 CHURCH ROAD MOUNT LAUREL NJ 08054 DISQUALIFICATION 7/16/2017MOURACHOV, PAVEL 8/26/1971 1083711121 3917 WEST ROAD, SUITE 137 LOS ALAMOS NM 87544 DISQUALIFICATION 12/29/2015MOZULAY, MARK J. MD 6/23/1957 1669631719 512 TOWNSHIP LANE BLUE BELL PA 19422 SUSPENSION 12/1/1998



76






EXPIRATION DATE

MUHAMMAD, ABDUL B. MD 11/19/1942 284 BROADWAY NEWARK NJ 07104 DISQUALIFICATION 11/8/2004 PERMANENT

MUHAMMAD, CHHA 3/10/1992 354 7TH AVENUE WEST NEWARK NJ 07107 DISQUALIFICATION 7/14/2017MUID, JANNAH 1/3/1984 671 LINCOLN AVENUE ORANGE NJ 07050 DISQUALIFICATION 11/18/2010MUISE, NICOLLETE CHHA 11/3/1990 172 FRANKLIN ROAD DENVILLE NJ 07834 DISQUALIFICATION 11/8/2017MUKHTAR, JUNAID 9/6/1960 114 BALDWIN AVENUE JERSEY CITY NJ 07306 SUSPENSION 6/5/1997MULLANGI, KUMAR R. MD 12/9/1965 SOUTH BROADWAY STREET BURLINGTON IA 52601 SUSPENSION 5/20/2008MULLIGAN, RACHEL M. 2/7/1978 241 HAWAII DRIVE BRICK NJ 08723 DISQUALIFICATION 4/11/2008MULTANI, GURMEET PSYCH 4/14/1955 1528225406 1055 CALLE DE LAS PALM REDLANDS CA 92373 DISQUALIFICATION 6/9/2011MUNGEN, JONETTA V. CHHA 9/30/1972 34 VERMONT AVENUE NEWARK NJ 07106 SUSPENSION 6/20/2001MUNN, DONIELLE CHHA 5/26/1984 150 HOME AVENUE, FL. 2 TRENTON NJ 08611 DISQUALIFICATION 2/8/2017MUNOZ, GUILLERMO DO 1/20/1965 1023071669 824 ELIZABETH AVENUE ELIZABETH NJ 07201 DEBARMENT 11/25/2015 5/13/2016MUNOZ, JULIO ANTHONY 1/22/1965 4 NORMAL AVENUE UPPER MONTCLAIR NJ 07043 DEBARMENT 10/26/2006MUNSIF, ANAND MD 11/10/1956 1982879805 127 E. NORTHFIELD ROAD LIVINGSTON NJ 07039 DEBARMENT 11/7/2011MUNZEL, GREGORY 3/5/1976 140 WAPPOO CREEK DRIVE CHARLESTON SC 29412 DEBARMENT 4/22/2012MURRAY, LAKIRAH LPN 10/2/1985 1311 NE 77TH AVENUE GAINESVILLE FL 32609 DEBARMENT 1/5/2018MURRY JR., TOMMIE 11/20/1958 2697 RAVEN ROAD CINNAMINSON NJ 08077 SUSPENSION 5/25/1999MURRY JR., TOMMIE 11/20/1958 2697 RAVEN ROAD CINNAMINSON NJ 08077 DEBARMENT 1/5/2001MURRY JR., TOMMIE 11/20/1958 2697 RAVEN ROAD CINNAMINSON NJ 08077 DEBARMENT 10/20/2002MUSARRA, GERALD C. DMD 1/3/1920 525 WASHINGTON AVENUE HOBOKEN NJ 07030 DISQUALIFICATIONMUSCIO, ROBERT MD 9/8/1973 1578510723 333 BROAD STREET RED BANK NJ 07701 DISQUALIFICATION 3/19/2015MYERS, HOWARD MD 10/30/1939 103 FAIRWAY TERRACE MOUNT LAUREL NJ 08054 DISQUALIFICATION 12/1/1998MYNDIUK, JAROSLAW MD 4/19/1910 96 TUXEDO PARKWAY NEWARK NJ 07106 DISQUALIFICATION 2/27/1988 DECEASEDNAGLE, BRITTANY RN 1/13/1988 709 NORTH VICTORIA VENTNOR CITY NJ 00840 DISQUALIFICATION 10/25/2016NAIMOLI, DANIELLE 7/8/1979 824 HOLIDAY COURT TOMS RIVER NJ 08753 SUSPENSION 9/30/2005NALBONE, PHILLIP C. RN 5/13/1969 24 RUNNING BROOK ROAD TRENTON NJ 08638 SUSPENSION 6/17/2004NANDI, ANINDITA MD 11/22/1972 1669563995 127 HIGHLAND AVENUE JERSEY CITY NJ 07306 DISQUALIFICATION 9/12/2018NAPENAS, VICTOR T. 1/4/1947 14 SPRUCE LANE PISCATAWAY NJ 08854 DISQUALIFICATION 5/20/2012NAPENAS, VICTOR T. 1/4/1947 14 SPRUCE LANE PISCATAWAY NJ 08854 DISQUALIFICATION 11/17/2011NARAYAN, PRITHVI MD 7/28/1961 1982699823 33 COOPER AVENUE, UNIT

213LONG BRANCH NJ 07740 DISQUALIFICATION 2/25/2021 PERMANENT

NARO, MARYANN LPN 5/15/1970 23 DOWNING ROAD HAMILTON NJ 08690 DISQUALIFICATION 5/25/2019NASH, JENNIFER RN/APN 11/30/1969 621 ASTER LANE RIVERVALE NJ 07675 DEBARMENT 7/3/2016NASSAU PHARMACY 80 NASSAU STREET PRINCETON NJ 08540 DISQUALIFICATION



77






EXPIRATION DATE

NASSERY, MOHAMMAD MD 4/18/1952 1992763510 59 TREELINE DRIVE MARSTONS MILLS MA 02648 DISQUALIFICATION 11/9/2016NATALE, JOSEPH 2/8/1962 216 NORTH AVENUE E, STE. CRANFORD NJ 07016 SUSPENSION 1/24/2014NATHAN, MICHAEL MD 11/3/1946 1578593422 1 PROSPECT LANE OKATIE SC 29909 DEBARMENT 8/1/2017NATIONAL SPINE MEDICAL CENTER

2103 GOLDEN POND DRIVE KINGWOOD TX 77345 SUSPENSION 4/20/2005

NATOVICH, BORIS 2/25/1947 996 PINE TERRACE FRANKLIN LAKES NJ 07417 SUSPENSION 9/18/2003NATOVICH, LEV 5/28/1968 996 PINE TERRACE FRANKLIN LAKES NJ 07417 SUSPENSION 9/18/2003NAVAZIO, DAVID 11/22/1960 1368 BRENTWOOD ROAD YARDLEY PA 19067 SUSPENSION 6/7/2000 1/5/2018NAYLOR, KIM M. PHARM

TECH9/15/1958 1504 TAMIAMI ROAD FORKED RIVER NJ 08731 DEBARMENT 9/19/2011

NAZARIO, JULISSA CHHA 6/6/1992 210 ROSEVILLE AVENUE, APT. NEWARK NJ 07107 DISQUALIFICATION 2/20/2017NEAL, LAYONA CHHA 4/5/1983 545 E. TOILE COURT BURLINGTON NJ 08016 DISQUALIFICATION 7/13/2018NEALS, SHERRY CHHA 12/19/1974 63 DALES AVENUE, APT. 1124 JERSEY CITY NJ 07306 SUSPENSION 9/20/2001NEGRI, MARY JEAN RN/DC 11/21/1956 1063594836 514 LAFAYETTE ROAD, SUITE SPARTA NJ 07871 DISQUALIFICATION 5/20/2015NEGRON, JOANNA CHHA 7/24/1982 1343 LANDSDOWNE AVENUE CAMDEN NJ 08104 DISQUALIFICATION 5/2/2017NELSON, SIDNEY MD 4517 BERGENLINE AVENUE UNION CITY NJ 07087 DEBARMENT 9/13/1999

NESSMAN, LAWRENCE DO 8/3/1931 143 GREENRALE AVENUE WAYNE NJ 07470 DISQUALIFICATION 6/24/1997NEWBY, YVONNE CHHA 11/20/1966 38 WINANS STREET, APT. 3 EAST ORANGE NJ 07018 DISQUALIFICATION 8/29/2017

NEWMAN, ALEXANDER PHD 11/8/1947 372 N. WOODLAND STREET ENGLEWOOD NJ 07631 DEBARMENT 3/10/1999NEWMAN, MICHAEL J. DMD 11/22/1954 192 GABRIEL TERRACE SOUTH AMBOY NJ 08879 DISQUALIFICATION 7/18/2001NEWMARK, MALINDA RN 2/7/1969 38 STONY HILL ROAD, APT. MONROE TOWNSHIP NJ 08831 SUSPENSION 5/19/2005NEWMARK, THOMAS PSYCH 12/8/1944 1740380997 2250 CHAPEL AVENUE CHERRY HILL NJ 08002 DISQUALIFICATION 12/19/2016 PERMANENTNEWMARK, THOMAS PSYCH 12/8/1944 1740380997 4700 CITY AVENUE, APT. PHILADELPHIA PA 19131 DISQUALIFICATION 4/17/2017 PERMANENTNEWSOME, DORITA DDS 1/22/1956 1306063235 163 CHAPEL STREET ORANGE NJ 07050 DISQUALIFICATION 1/23/2009NEWTON, ANDREW PSYCH 12/18/1961 1154349330 129 EAST 5TH STREET MOUNT CARAMEL PA 17851 DISQUALIFICATION 11/20/2015NGOAJIA, MARK 7/23/1987 403 WILLOW POINT DRIVE JACKSON NJ 08724 DEBARMENT 12/16/2015NGUYEN, TONY MD 10/7/1979 1083872675 10294 GREENSPIRE DRIVE OAKTON VA 22124 DISQUALIFICATION 9/28/2017NIAZ, ASIM 7/11/1960 PO BOX 420 FAIRTON NJ 08320 SUSPENSION 8/19/2010NICHOLSON, BEVERLY CNA 6/3/1947 139 HOLLYWOOD AVENUE EAST ORANGE NJ 07108 DISQUALIFICATION 1/13/2006NICOLL, DAVID G. 3/10/1974 312 BOULEVARD MOUNTAIN LAKES NJ 07046 SUSPENSION 1/21/2015 7/4/2019NICOLL, DAVID G. #65321- 3/10/1974 USP CANAAN, PO BOX 300 WAYMART PA 18472 DISQUALIFICATION 7/4/2019NICOLL, SCOTT R. 9/20/1980 120 BUNKER HILL ROAD WAYNE NJ 07470 SUSPENSION 1/21/2015



78






EXPIRATION DATE

NICOSIA, BETTY LOU 6/23/1945 204 CIRCLE DRIVE STEUBENVILLE OH 43953 DISQUALIFICATION 12/29/2015NIELSON, STEVEN C. DPM 10/22/1963 1538595772 845 DAWN AVENUE EPHRATA PA 17522 SUSPENSION 3/23/2009NIGALAN, MANUEL MD 12/5/1943 1497809909 8 MIMI COURT NORTHFIELD NJ 08225 DISQUALIFICATION 10/14/2010NII, ROBERT PA 12/25/1965 1124254107 34 MILL BROOK ROAD PISCATAWAY NJ 08854 DISQUALIFICATION 9/21/2016 PERMANENTNINOS, DIANE E. 12/11/1975 569 E. 33RD STREET PATERSON NJ 07613 DISQUALIFICATION 3/28/2001NISBETT, MELVIN CHHA 6/23/1990 205 LA CASCATA CLEMENTON NJ 08021 DISQUALIFICATION 2/8/2017NISIVOCCIA, CHARLES DC 1/29/1967 260 MAIN STREET LITTLE FALLS NJ 07424 SUSPENSION 8/20/2006NISLER, JANIS RN 8/23/1984 127 WEST WOODBRIDGE ISELIN NJ 08830 DISQUALIFICATION 1/24/2019NOBLES, MARITZA CHHA 9/2/1986 34 CENTER OAK AVENUE LAWNSIDE NJ 08045 DISQUALIFICATION 2/8/2017NOBORE, ABIEYUWA CHHA 7/20/1986 776 SOUTH 13TH STREET NEWARK NJ 07108 DEBARMENT 2/20/2017NOEL, EDWARD LPN 8/9/1980 469 E. 93RD STREET, APT. 6 BROOKLYN NY 11212 DISQUALIFICATION 10/25/2019NONCENT, JENNIFER CHHA 6/2/1994 949 CARTERT AVENUE UNION NJ 07083 DISQUALIFICATION 2/8/2017NONZIATO, CHARLES G. DO 2/26/1915 247 CENTER STREET TRENTON NJ 08611 DISQUALIFICATION 11/13/1991 DECEASED

NOOR, FARID A. MD 6/26/1956 1770751513 5 GITHERS LANE MEDFORD NJ 08055 SUSPENSION 4/12/2004NOOR, FARID A. MD 6/26/1956 1770751513 350 A DELANCEY PLACE MOUNT LAUREL NJ 08054 DISQUALIFICATION 8/19/2008NOOR, FARID A. MD 6/26/1956 1770751513 596 ANDERSON AVENUE CLIFFSIDE PARK NJ 07010 DEBARMENT 1/30/2015NORDMAN, CRAIG J. 11/14/1978 4 ERNA PLACE WHIPPANY NJ 07981 SUSPENSION 1/21/2015 5/18/2019NORDMAN, CRAIG J. 11/14/1978 FCI SCHUYKILL, PO BOX 759 MINERSVILLE PA 17954 DISQUALIFICATION 5/18/2019

NORTH END FAMILY MEDICAL CARE, INC.

1013079888 644 MT. PROSPECT AVENUE NEWARK NJ 07104 DISQUALIFICATION 7/20/2018

NORTHGATE 156 COUNTRY FARM ROAD MARLTON NJ 08053 DISQUALIFICATION 3/6/2006NOWINSKI, VANESSA AKA RN 3/21/1977 65 LOCUST AVENUE NORTH ARLINGTON NJ 07031 SUSPENSION 9/19/2003NSIAH, KENNETH CHHA 6/25/1985 827 S. 17TH STREET, 2ND FL. NEWARK NJ 07108 DEBARMENT 7/14/2017NTSHONA, NOKUZOLA S. MD 9/25/1951 113-15 34TH AVENUE, #4B CORONA NY 11368 DEBARMENT 1/12/2000NURIK, BARUCH APT 9C PARKVIEW & LAURENCE HARBOR NJ 08879 DISQUALIFICATION 4/30/1995NUSSBAUM, ABRAHAM MD 7/28/1950 1578598082 91 MONTGOMERY STREET RHINEBECK NY 12572 SUSPENSION 1/15/2001 11/12/2013NUTT, TRACY RN 9/15/1963 27 OVERLOOK DRIVE MOUNT LAUREL NJ 08054 DISQUALIFICATION 5/11/2019NWANKWO, FESTUS RPH 7/27/1959 154 BLOOMFIELD AVENUE NEWARK NJ 07104 DISQUALIFICATION 11/18/1998NWANKWO, FESTUS RPH 7/27/1959 306 ARDSDALE TERRACE UNION NJ 07083 DISQUALIFICATION 2/18/1999NWANKWO, RAPHAEL 7/4/1949 278 PARK AVENUE NEWARK NJ 07107 DISQUALIFICATION 5/19/1999O'BRIEN, ELIZABETH AKA 9/2/1960 2201 BENJAMIN FRANKLIN PHILADELPHIA PA 19130 DISQUALIFICATION 5/18/2019O'CALLAGHAN, TERESE RN 12/12/1958 5122 ORCHARD WAY PENNSAUKEN NJ 08109 SUSPENSION 10/20/2002



79






EXPIRATION DATE

OCANSEY, DONNA RN 2/1/1962 7 WISINA COURT MEDFORD NJ 08055 DEBARMENT 4/22/2012 7/19/2019OCCEAN, NERLANDE CHHA 9/29/1974 811 DILL AVENUE LINDEN NJ 07036 DISQUALIFICATION 2/8/2017O'CONNELL, MARK MD 2/19/1954 1669514253 18 CENTER STREET, REAR RUMSON NJ 07760 DEBARMENT 11/9/2015ODOMS, TIFFANY E. 9/3/1983 926 TILGHMAN STREET CHESTER PA 19013 DISQUALIFICATION 11/18/2008O'DONNELL, KATHERINE 1/23/1975 141 MAIN STREET METUCHEN NJ 08840 DISQUALIFICATION 9/30/2005O'DONNELL, LISA RN 5/12/1976 845 BROADWAY BAYONNE NJ 07002 DISQUALIFICATION 6/15/2018O'DONNELL, WILLIAM DC 9/15/1976 1659601177 7 NINEBACK LANE OXFORD NJ 07863 DISQUALIFICATION 3/28/2019ODUNZEH, UCHE 10/28/1981 3565 LAUREL FORTE MEADE LAUREL MD 20724 DISQUALIFICATION 11/20/2015OFFOR, CHINWE MD 3/4/1962 1508811019 15 CHABLIS DRIVE DIX HILLS NY 11746 DISQUALIFICATION 4/11/2019OFFOR, CHINWE MD 3/4/1962 1508811019 15 CHABLIS DRIVE DIX HILLS NY 11746 DISQUALIFICATION 6/12/2019OGANDO LOPEZ, CHHA 7/27/1985 943 SHERIDAN AVENUE ELIZABETH NJ 07208 DEBARMENT 4/18/2017 6/28/2018OGBEIDE-SIMMS, RACHEL CHHA 10/27/1965 15 MAPES PLACE NEWARK NJ 07112 DISQUALIFICATION 2/8/2017OGORODOVA, GANNA CHHA 6/17/1983 310 BROMLEY PLACE EAST BRUNSWICK NJ 08816 DISQUALIFICATION 2/20/2017OGUNTUASE, EBENEZER PHY 10/16/1959 10 DOCKSIDE DRIVE EGG HARBOR NJ 08234 DISQUALIFICATION 6/20/2009O'HERN, DANIEL MD 3/8/1950 1144369554 18 FLEETWOOD DRIVE GOSHEN NY 10924 DISQUALIFICATION 3/3/2017 PERMANENTOJAH CORPORATION 42/44 SUSSEX AVENUE EAST ORANGE NJ SUSPENSION 3/22/2006OJIKYTU, SIMBIAT T. CHHA 5/5/1987 51 LEXINGTON BLVD BARNEGAT NJ 08005 DISQUALIFICATION 5/2/2014OJO, RICHARD O. 9/10/1986 346 FIELDCREST AVENUE NEW EGYPT NJ 08533 DEBARMENT 2/24/2009OKANTA, MARGARET CHHA 11/11/1941 1854B MANOR DRIVE UNION NJ 07083 DEBARMENT 7/30/2005OKOYE, GODWIN S. RPH 1/1/1962 289 GEORGE STREET NEW BRUNSWICK NJ 08901 SUSPENSION 1/12/2001OKOYE, PATRICK C. RPH 5/2/1970 289 GEORGE STREET NEW BRUNSWICK NJ 08901 SUSPENSION 1/12/2001OKREM, JANINE RN 10/21/1970 1112 HARKER AVENUE WEST DEPTFORD NJ 08096 DISQUALIFICATION 7/12/2018OLDE MEDFORD 1619148632 639 STOKES ROAD, SUITE 101 MEDFORD NJ 08055 DISQUALIFICATION 4/13/2018OLIVEIRA JR., MARIO OD 4/8/1963 170 EAST KINNEY STREET NEWARK NJ 07105 DEBARMENT 4/28/2005OLIVER, ANDREA AKA APN/RN 7/26/1979 1780630418 70 COHANSEY STREET BRIDGETON NJ 08302 DISQUALIFICATION 9/12/2016 5/21/2020OLIVER, JAMES DDS 3/1/1946 1134314594 167 MAIN STREET METUCHEN NJ 08840 DEBARMENT 8/13/1999OLIVERA, PABLO R. DPM 4/28/1958 2 CEDAR STREET NEWARK NJ 07102 SUSPENSION 9/20/2001OLIVERA, SMIRNA LPN 8/15/1958 33 REMSEN AVENUE NEW BRUNSWICK NJ 08901 SUSPENSION 10/20/2002OLIVEROS, APRIL LPN 4/2/1985 233 SMOKERISE LANE TOMS RIVER NJ 08755 DISQUALIFICATION 6/5/2017OLIYNYK, OKSANA CHHA 5/9/1970 591 MARLBORO ROAD OLD BRIDGE NJ 08857 DEBARMENT 2/20/2017OMAR, HATIEM 4/20/1966 1116 ANNE STREET ELIZABETH NJ 07201 DISQUALIFICATION 11/10/1999OMAR, MUGAHID O. 3/29/1967 7-11 TONNELLE AVENUE JERSEY CITY NJ 07306 DISQUALIFICATION 3/14/1998OMAR, MUGAHID O. 3/29/1967 7-11 TONNELLE AVENUE- JERSEY CITY NJ 07306 DISQUALIFICATION 4/10/1997O'NEILL - RYAN, LISA COUNSE 8/20/1961 415 LYNDALE STREET PHILLIPSBURG NJ 08865 DISQUALIFICATION 8/17/2008



80






EXPIRATION DATE

O'NEILL - RYAN, LISA COUNSE 8/20/1961 415 LYNDALE STREET PHILLIPSBURG NJ 08865 SUSPENSION 5/9/2008ONYEKAHA, EBERE RPH 11/15/1958 13 HIGHLAND AVENUE MAPLEWOOD NJ 07040 DISQUALIFICATION 12/1/1998ONYENSO, CHIKEZIE MD 9/18/1958 1578605812 552 MAIN STREET CHATHAM NJ 07928 SUSPENSION 2/15/2012 5/6/2021ONYENSO, CHIKEZIE MD 9/18/1958 1578605812 18 EDINBURGH DRIVE RANDOLPH NJ 07869 DISQUALIFICATION 3/19/2015 5/6/2021OPOKU, BISMARK CHHA 6/14/1968 2468 ANGLER ROAD COLUMBUS OH 43224 DISQUALIFICATION 4/6/2018OQUENDO, BASHIRAH CHHA 11/6/1986 87 MANNING AVENUE PLAINFIELD NJ 07060 DISQUALIFICATION 2/8/2017ORANGE COMMUNITY 345 HENRY STREET ORANGE NJ 07055 SUSPENSION 3/16/2012O'REILLY, MARGARET RN 11/30/1957 38 REILEY MOUNTAIN ROAD CUDDEBACKVILLE NY 12729 DISQUALIFICATION 2/25/2019O'REILLY, RAYMOND B 2/20/1949 188 ALEXANDRIA DRIVE HACKETTSTOWN NJ 07840 DISQUALIFICATION 6/1/1993OREM, SUSAN RN 5/18/1960 140 VALERIE DRIVE #488 MANVILLE NJ 08835 SUSPENSION 9/20/2006ORIA, CONRAD RN 7/26/1976 525 BLOOMFIELD AVENUE CALDWELL NJ 07006 DEBARMENT 6/5/2017ORT II, CHARLES C. PA 10/4/1957 PO BOX 481 HACKETTSTOWN NJ 07840 DISQUALIFICATION 11/18/2004ORTEGA, ANA CHHA 11/16/1967 14 PALM STREET MONMOUTH

JUNCTIONNJ 08852 DISQUALIFICATION 2/8/2017

ORTEGA, VICTOR 10/14/1967 GUAYNBO- PO BOX 2147 SAN JUAN PR 00922 SUSPENSION 7/18/2002ORTELL, CARL RPH 7/30/1937 221 TINDERBOX LANE MARLTON NJ 08053 DISQUALIFICATION 12/5/1983OSAIGBOVO, ASHLEY CHHA 3/25/1994 130 PAMPHYLIA AVENUE, BRIDGETON NJ 08302 DISQUALIFICATION 10/19/2017OSEI, CALVIN RPH 8/24/1977 1497931794 2 SYSLO COURT SAYREVILLE NJ 08872 DISQUALIFICATION 9/4/2012 6/12/2018OSEI, FRANCIS LPN 4/9/1966 50 N. EVERGREEN ROAD, EDISON NJ 08837 DISQUALIFICATION 8/24/2017OSEI, PASCAL RPH 11/11/1958 9 SOUTH GROSSER PLACE SOMERSET NJ 08873 DEBARMENT 7/17/2009 7/17/2014OSIFO, BAHEEJAH CHHA 9/11/1979 530 PARK AVENUE ORANGE NJ 07050 DISQUALIFICATION 2/8/2017OSMANOFF, GARY DDS 5/13/1962 1710188073 NETTER COURT MARLBORO NJ 07746 DISQUALIFICATION 6/23/2008OSMANOFF, GARY DDS 5/13/1962 1710188073 317 MARINE AVENUE BROOKLYN NY 11209 SUSPENSION 12/17/2008OSTERGAARD, PAUL MD 3/15/1941 1962504753 230 WEST PARKWAY POMPTON PLAINS NJ 07444 DEBARMENT 2/21/2014OSTERGAARD, PAUL MD 3/15/1941 1962504753 15 MOUNTAIN AVENUE POMPTON PLAINS NJ 07444 DISQUALIFICATION 2/11/2016OSTERGAARD, PAUL MD 3/15/1941 1962504753 230 WEST PARKWAY POMPTON PLAINS NJ 07444 DEBARMENT 12/16/2015OSTROSKIE, JOAN LPN 4/3/1953 424 FLORENCE STREET NEW MILFORD NJ 07646 SUSPENSION 1/19/2003OSTWALD, ALICE LPN 2/7/1962 11 RAILROAD LANE WHITEHOUSE NJ 08889 SUSPENSION 9/20/2006OSUJI, PAUL 12/7/1963 FCI FORT DIX, PO BOX 2000 FORT DIX NJ 08640 SUSPENSION 8/20/2009OSWARI, DANIEL MD 6/11/1971 1265506489 35 ALLEGHANY LANE BORDENTOWN NJ 08505 DISQUALIFICATION 6/30/2020OTI, CHUCK B. 9/1/1973 676 PARK AVENUE, BLDG. EAST ORANGE NJ 07017 DISQUALIFICATION 1/31/2000OTISMED CORPORATION 1600 HARBOR BAY ALAMEDA CA 94502 DISQUALIFICATION 4/27/2015OTOO, LOVE CHHA 5/21/1957 555 ELIZABETH AVENUE NEWARK NJ 07112 DISQUALIFICATION 2/8/2017OTTENSTEIN, ALAN MD 6/1/1956 3100 PRINCETON PIKE LAWRENCEVILLE NJ 08648 SUSPENSION 3/1/2009



81






EXPIRATION DATE

OTTENSTEIN, ALAN MD 6/1/1956 173 MOUNT EYRE ROAD WASHINGTON PA 18977 SUSPENSION 5/19/2005OWUSU, NICHOLAS CHHA 2/3/1955 6063 HAMPSTEAD DRIVE W COLUMBUS OH 43229 DISQUALIFICATION 2/27/2017 PERMANENT

OWUSU,-ANSAH, GRACE CHHA 9/21/1963 97-22 57TH AVENUE CORONA NY 11368 DISQUALIFICATION 5/17/2018OXFORD DIABETIC 1700016045 53 FRONTAGE ROAD, SUITE HAMPTON NJ 08827 DISQUALIFICATION 12/8/2016OXMAN, REED S. MD 3/8/1959 1649575473 226 W. RITTENHOUSE

SQUAREPHILADELPHIA PA 19103 SUSPENSION 3/16/2012

OYENUSI, ADEBOWALE RPH 4/4/1956 90 WASHINGTON STREET EAST ORANGE NJ 07017 DEBARMENT 10/14/2000OZERY, TZIPORA AKA 2/1/1969 27 FIRETOWER ROAD BUDD LAKE NJ 07828 DEBARMENT 9/15/2017PABBATHI, RAMMOHAN 11/25/1946 3 AMY COURT HOWELL NJ 07731 DEBARMENT 7/8/2005PACHECO, ALVARO R. 59 EDGEHILL COURT WEST ORANGE NJ 07052 DISQUALIFICATION 6/1/1993PACHECO, MICHAEL PHARM

TECH9/2/1975 84 LAFAYETTE AVENUE PASSAIC NJ 07055 DEBARMENT 7/18/2003

PADUANO JR., FRANCIS P. RPH 10/15/1947 2020 BALMORAL AVENUE UNION NJ 07735 DISQUALIFICATION 9/16/1986

PADVA-GERMAN, ANNA DDS 8/21/1962 1043382039 446 DUBLIN PLAZA SECAUCUS NJ 07094 DEBARMENT 12/14/2009 3/24/2021PADVA-GERMAN, ANNA DDS 8/21/1962 1043382039 446 DUNLIN PLAZA, 446H SECAUCUS NJ 07094 DEBARMENT 10/15/2014 3/24/2021PAGANO, NICOLE RN 4/5/1973 531 PARKWAY AVENUE TRENTON NJ 08618 DISQUALIFICATION 5/20/2009PAGONZAGA, GLORIA CHHA 12/20/1950 313 OLD BERGEN ROAD, APT. JERSEY CITY NJ 07305 DISQUALIFICATION 2/20/2017PAKETT, NEIL DMD 7/18/1950 1184934663 777 WEST GERMANTOWN

PIKE, APT. 530PLYMOUTH MEETING PA 19462 DISQUALIFICATION 11/20/2015

PALMER, AMANDA LPN 3/24/1983 14 E. MAIN STREET, APT. 4 CLINTON NJ 08809 DISQUALIFICATION 3/13/2019PALMER, THOMAS #14570-003

RN 5/31/1975 1912200932 FPC PENSACOLA, PO BOX 3949

PENSACOLA FL 32516 DISQUALIFICATION 9/29/2017

PAMIDIMUKKALA, VIJAY RPH 8/14/1951 1598087272 3 PENROSE COURT EDISON NJ 08820 SUSPENSION 9/13/1999PANCELLI, JOHN M. MD 11/26/1961 WEST JERSEY HOSPITAL CAMDEN NJ 08104 DISQUALIFICATION 12/1/1998 DECEASEDPANGANIBAN, ARMANDO RN 1/5/1953 CYPRESS ROAD TOMS RIVER NJ 08753 DISQUALIFICATION 8/11/2007

PANICHELLA, ANTHONY COUNSE 1/16/1955 739 S. WHITE HORSE PIKE AUDUBON NJ 08106 SUSPENSION 7/20/2006PANITCH, EDWIN RPH 1/1/1931 8 POINT OF WOODS DRIVE NORTH BRUNSWICK NJ 08902 DISQUALIFICATION 6/1/1993PANJWANI, HARRY K. MD 6/1/1927 EAST 42 FAIRVIEW TERRACE PARAMUS NJ 07652 DEBARMENT 5/24/1999

PANOS, SPYROS MD 9/30/1968 1497753149 USP CANAAN, PO BOX 300 WAYMART PA 18472 DISQUALIFICATION 11/20/2015



82






EXPIRATION DATE

PAPPALARDO, PETER S. MD 6/27/1937 4 SOUTH AIRMONT ROAD SUFFERN NY 10901 DISQUALIFICATION 6/1/1993PARADISO, NINO RPH 8/20/1943 57 POPLAR DRIVE MORRIS PLAINS NJ 07950 DISQUALIFICATION 9/9/2016PARCHMENT, ALFRED MD 12/31/1962 1073587242 1140 BURT TAVERN ROAD BRICK NJ 08724 DISQUALIFICATION 10/25/2016PAREKH, CHANDRAKANT DDS 6/30/1948 1144386178 6529 GERMANTOWN

AVENUEPHILADELPHIA PA 19119 DISQUALIFICATION 11/20/2015

PARIDA, SAROJ K. MD 10/21/1959 1013975549 USP LEWISBURG-PO BOX 1000

LEWISBURG PA 17837 DISQUALIFICATION 8/20/2013

PARIKH, BIPIN J. MD 8/4/1945 1962555193 224 LAFAYETTE STREET WILLISTON PARK NY 11596 SUSPENSION 11/20/2010PARIKH, BIPIN J. MD 8/4/1945 1962555193 224 SOUTH LAFAYETTE WILLISTON PARK NY 11596 SUSPENSION 7/9/2008PARIKH, MANUPRASAD RPH 6/23/1941 209 STOKES FARM ROAD FRANKLIN LAKES NJ 07417 SUSPENSION 7/20/2004 9/5/2017PARK MEDICAL 298 CLAIRMONT AVENUE MONTCLAIR NJ 07042 DISQUALIFICATION 8/20/1976PARKOFF, MICHAEL A. DMD 9/3/1948 68 MAPLEWOOD SUFFERIN NY 10901 DISQUALIFICATION 8/7/1984PARTNERS FOR HOPE, PC 1689883001 365 RIFLE CAMP ROAD, WOODLAND PARK NJ 07424 DISQUALIFICATION 1/17/2019 4/24/2019PASCUCCI, LAVERNE CHHA 7/5/1946 160 JAMES STREET TOMS RIVER NJ 08753 DISQUALIFICATION 2/8/2017PATANKAR, SANJIV MD 5/9/1958 1255429361 61 HARDWICK DRIVE KENDALL PARK NJ 08824 DEBARMENT 12/19/2017PATEL, ARUNA S. MD 11/1/1944 1770568610 725 NORTH BROAD STREET ELIZABETH NJ 07208 DISQUALIFICATION 6/26/2008PATEL, ASHOKKUMAR R. 5/14/1961 11 YARDLEY STREET EDISON NJ 08820 DISQUALIFICATION 8/10/2007PATEL, BELA RPH 8/15/1979 1701 COTTMAN AVENUE PHILADELPHIA PA 19111 DISQUALIFICATION 4/9/2015PATEL, BHARAT KUMAR RPH 7/15/1966 1962729731 140 RIVERSIDE BOULEVARD NEW YORK NY 10069 DISQUALIFICATION 4/20/2014PATEL, CHANDRAKANT 40 GALESI DRIVE WAYNE NJ 07470 SUSPENSION 3/28/2000 12/12/2007PATEL, CHIRAG J. 9/22/1975 16 SNEIDER ROAD WARREN NJ 07059 SUSPENSION 4/2/2012PATEL, CHIRAG J. 9/22/1975 16 SNEIDER ROAD WARREN NJ 07059 DISQUALIFICATION 4/20/2015PATEL, DINESH R. MD 3/6/1954 1285702829 3 BRIGHTON COURT LIVINGSTON NJ 07039 SUSPENSION 3/17/2012 PATEL, DINESH R. MD 3/6/1954 1285702829 835 CLINTON AVENUE NEWARK NJ 07108 DISQUALIFICATION 2/20/2014PATEL, DINESH R. MD 3/6/1954 1285702829 3 BRIGHTON COURT LIVINGSTON NJ 07039 DISQUALIFICATION 9/27/2017PATEL, HARISH AKA MD 3/13/1965 GB-46 PO BOX 26010 BEAUMONT TX 77720 SUSPENSION 11/20/2006PATEL, MAHESH I. MD 10/26/1949 1942202841 3 PINE VALLEY WAY FLORHAM NJ 07932 DISQUALIFICATION 1/26/2015 11/9/2020PATEL, MEHMOOD M. MD 5/25/1945 1225074859 201 MIDDLETON ROAD LAFAYETTE LA 70503 DISQUALIFICATION 2/26/2010PATEL, PARESH R. DMD 6/7/1965 1134106511 295 MAIN STREET METUCHEN NJ 08840 DISQUALIFICATION 5/22/2014PATEL, PARESHCHANDRA MD 8/24/1960 1306073200/1 8 NOTTINGHAM ROAD EDISON NJ 08820 DEBARMENT 11/21/2016PATEL, PRAVIN, K. MD 5/17/1957 904 #35 IVY RIDGE ROAD SYRACUSE NY 13210 SUSPENSION 12/19/2002PATEL, RAMBEN LPN 7/31/1953 505 WEST MINISTER PARLIN NJ 08859 SUSPENSION 8/20/2000PATEL, RAMESH SHANKER RN 8/15/1959 PO BOX 5564 OLD BRIDGE NJ 08857 SUSPENSION 6/20/2001PATEL, RITA RPH 6/2/1965 4 HAUSER LANE MATAWAN NJ 07747 SUSPENSION 3/10/2016 2/17/2017



83






EXPIRATION DATE

PATEL, RITA RPH 6/2/1965 4 HAUSER LANE MATAWAN NJ 07747 DEBARMENT 3/20/2017 10/19/2017PATEL, RITA RPH 6/2/1965 4 HAUSER LANE MATAWAN NJ 07747 DISQUALIFICATION 10/19/2017PATEL, SANJAY I. RPH 6/4/1965 1316335961 63 HEATHERDELL ROAD ARDSLEY NY 10502 DEBARMENT 4/26/2016PATEL, SANJAY I. RPH 6/4/1965 1316335961 63 HEATHERDELL ROAD ARDSLEY NY 10502 SUSPENSION 4/20/2006PATEL, SHIRJAY CHHA 6/12/1993 703 NEW DOVER ROAD EDISON NJ 08820 DISQUALIFICATION 2/20/2017PATEL, VIJAY 1/1/1957 65 W. LINCOLN AVENUE ROCKAWAY NJ 07866 DISQUALIFICATION 11/20/2017PATEL, VITTHAL I. RPH 5/31/1954 ST. GEORGE AVENUE, APT. AVENEL NJ 07001 SUSPENSION 9/20/2004PATHAK, VINEETA MD 12/16/1963 1104922939 533 LEAWOOD AVENUE TOMS RIVER NJ 08755 DISQUALIFICATION 10/29/2019PATHARKAR, MANOJ MD 4/13/1971 1598808339 16 LINDA COURT LAURENCE HARBOR NJ 08879 DISQUALIFICATION 12/19/2016 PERMANENTPATIN, YURY MD 9/8/1956 1548325400 45 BEVERLY ROAD SUMMIT NJ 07901 DISQUALIFICATION 2/26/2009PATTERSON JR., ARTHUR DC 5/2/1958 1164628822 8 FELLOWSWOOD WAY HOLMDEL NJ 07733 DEBARMENT 7/18/2014PATTERSON, KELEE RN 3/3/1986 577 EAST ROAD BELFORD NJ 07718 DISQUALIFICATION 6/28/2017PAUL, DAVID M. MD 5/6/1948 1124355250 434 RAHWAY AVENUE WOODBRIDGE NJ 07095 DEBARMENT 3/22/2002PAYANO, VIANNE AKA CHHA 10/2/1982 710 EAST 18TH STREET PATERSON NJ 07501 DISQUALIFICATION 1/31/2017PEACOCK, DENISE RN 9/8/1978 9331 GLENLOCH STREET PHILADELPHIA PA 19114 DISQUALIFICATION 11/20/2015PEARSON, KATIE LPN 6/19/1981 229 SNOOKS HILL ROAD LEWISTOWN PA 17044 DISQUALIFICATION 11/20/2015PEARSON, SHAMERA CHHA 5/1/1990 2824 N. BAMBREY STREET PHILADELPHIA PA 19132 DISQUALIFICATION 7/16/2019 PERMANENTPEART, HAROLD G. LCSW 8/31/1932 3 HARRISON PARK LANE BURLINGTON NJ 08016 SUSPENSION 3/17/2000PEART, HAROLD G. LCSW 8/31/1932 415 KEIM BOULEVARD BURLINGTON NJ 08016 SUSPENSION 8/20/1999PECK, MARVIN RPH 5/18/1937 335 GEORGE STREET NEW BRUNSWICK NJ 08901 DISQUALIFICATION 6/1/1993PELLEGRINO, TAMMY RN 8/20/1964 2423 SHADY LANE, APT. P ATCO NJ 08004 SUSPENSION 2/20/2003PELLICANO, PAUL J. MD 6/25/1939 1316282783 120 MILLBURN AVENUE, STE. MILLBURN NJ 07041 DISQUALIFICATION 12/1/1998PEMBERTON, COLIN MD 5/6/1975 1891935557 500 ORANGE STREET NEWARK NJ 07107 DISQUALIFICATION 8/28/2017 4/26/2018PEMBERTON, COLIN MD 5/6/1975 1891935557 2 DEVONSHIRE TERRACE WEST ORANGE NJ 07052 DISQUALIFICATION 10/8/2019 PENA, CARMEN F. DDS 8/29/1961 1871750166 800 76TH STREET, 2ND NORTH BERGEN NJ 07047 SUSPENSION 9/20/2000 9/15/2015PENALES, AMANDO D. 7/30/1973 BAYSIDE STATE PRISON, PO LEESBURG NJ 08327 DISQUALIFICATION 5/9/2014PENALVER, FAITH RN 10/5/1943 4 MAPLE COURT ROOSEVELT NJ 08555 SUSPENSION 5/19/2005PENFIELD, JOHN DO 9/18/1967 1528078839 25 POCONO ROAD DENVILLE NJ 07834 DEBARMENT 3/6/2014 3/2/2018PENFIELD, JOHN DO 9/18/1967 1528078839 308 MURRAY HILL ROAD VESTAL NY 13850 DISQUALIFICATION 11/20/2015 3/2/2018PENICO, PETER MD 10/25/1915 300 MAIN STREET MILLVILLE NJ 08332 DISQUALIFICATION 8/24/1978 DECEASEDPENNANT GRAY, SONIA CHHA 4/27/1973 491 PARK AVENUE EAST ORANGE NJ 07017 DISQUALIFICATION 7/26/2019 PERMANENTPEOPLE CHOICE HOME 1851416069 430 MORRIS AVENUE ELIZABETH NJ 07208 DISQUALIFICATION 5/24/2017PEPE, ANTHONY 8/18/1977 111 E. MIAMI AVENUE CHERRY HILL NJ 08034 DEBARMENT 7/1/2019PERERA, SANTUSHT MD 9/29/1961 1942311147 7 GREENHILL ROAD KINNELON NJ 07405 DISQUALIFICATION 12/22/2016 PERMANENT



84






EXPIRATION DATE

PEREZ, JORGE MD 9/24/1944 213 14TH STREET PALISADES PARK NJ 07650 SUSPENSION 3/18/2004PEREZ, JUANA CHHA 4/18/1963 510 25TH STREET UNION CITY NJ 07087 DISQUALIFICATION 2/20/2017PERLMAN, BERNARD MD 9/8/1952 1477579456 42 OAKMONT ROAD YARMOUTH PORT MA 02675 DEBARMENT 1/3/2000 9/12/2017PERRIN, DOUGLAS M. CHHA 4/18/1968 1801 LAURAL ROAD LINDENWOLD NJ 08021 SUSPENSION 5/20/2002PERRY, ELSWETTA CHHA 9/20/1955 291 NORTH PARK STREET, EAST ORANGE NJ 07017 DISQUALIFICATION 3/12/2018PESCIOTTA, BARBARA ANN

RPH 10/9/1966 992 VAUGHN AVENUE TOMS RIVER NJ 08753 DEBARMENT 5/18/2006

PESCIOTTA, ROY THOMAS RPH 5/29/1967 992 VAUGHN AVENUE TOMS RIVER NJ 08753 DEBARMENT 5/18/2006PETERS, MEAGHAN RN 8/25/1980 707 BUCHANAN STREET, APT. TOMS RIVER NJ 08753 DISQUALIFICATION 6/29/2019PETERSEN, PETHINA CHHA 1/23/1955 289 MLK DRIVE JERSEY CITY NJ 07305 SUSPENSION 5/20/2004PETIT, MADELINE CNA 2/13/1951 228 70TH STREET, 2ND FL. GUTTENBERG NJ 07093 DISQUALIFICATION 7/7/2008

PETRUCELLI, SALVATORE MD 2/22/1950 201 LYONS AVENUE NEWARK NJ 07112 DEBARMENT 2/2/2000

PETTERSEN, LINDA A. RN 5/8/1955 700 PARK BOULEVARD CHERRY HILL NJ 08002 SUSPENSION 10/20/2002PFAUTZ, JOANNA LPN 10/17/1973 1595 BREAKERS DRIVE, #A MANAHAWKIN NJ 08050 DISQUALIFICATION 5/2/2018PHARES, ALYSSA RN 7/25/1971 21 WOODLAND WAY DAYTON NJ 08810 SUSPENSION 9/19/2002PHILEMON, MENAHEM CHHA 1/1/1980 265 KING VILLAGE BUDD LAKE NJ 07869 DISQUALIFICATION 5/18/2018PHILIPPE, ADELINE CHHA 1/30/1967 61 CLEVELAND STREET, APT. ORANGE NJ 07050 DISQUALIFICATION 3/12/2018PHILIPPE, IRLANDE RN 4/16/1966 29 ELM STREET WEST ORANGE NJ 07052 DISQUALIFICATION 7/22/2017PHILLIPS, RONALD DO 12/17/1944 718 HAVEN PLACE LINDEN NJ 07026 DEBARMENT 1/8/1999PHIPPS JR., ERNEST MD 11/6/1963 130 FORD ROAD HOWELL NJ 07731 SUSPENSION 5/20/2004PIACENTILE, JOSEPH MD 4/3/1956 1265607410 578 BIG OAK ROAD YARDLEY PA 19067 DISQUALIFICATION 12/17/1995PIAZZA, GARY G. DO 3/28/1952 7 CARRIAGE PLACE EDISON NJ 08820 DISQUALIFICATION 10/20/1998PICARIELLO, JOSEPH 12/18/1954 1202 FOX CHASE LANE WHIPPANY NJ 08981 DISQUALIFICATION 6/9/2000 6/1/2016PIERCE, JACQUELINE CHHA 4/2/1986 1066 NORTH 28TH STREET CAMDEN NJ 08105 DEBARMENT 7/14/2017PIERCE, LESLIE CHHA 3/31/1968 511 1ST AVENUE, APT. #3-W ASBURY PARK NJ 07712 DEBARMENT 3/6/2018PIERRE, OTILIEN CHHA 2/10/1972 454 SOUTH OLDEN AVENUE TRENTON NJ 08609 DISQUALIFICATION 2/20/2017

PIERSON, GEORGE T. DO 9/1/1929 5 RAINBOW TRAIL SPARTA NJ 07871 DISQUALIFICATION 4/2/1988 DECEASEDPIMPONG, SWANZYBELLA LPN/RN/ 9/3/1975 14 3RD STREET, FLOOR 1 NEWARK NJ 07107 DISQUALIFICATION 3/3/2017PINEDA, FRANCESCA RN 3/9/1950 151 TRAILS END NEW CITY NY 10956 SUSPENSION 10/18/2001PINKERTON, MARIAN LPN 6/20/1957 410 THOMAS AVENUE RIVERTON NJ 08077 SUSPENSION 9/19/2003PINNAMARAJU, VENKATA RPH 5/23/1977 5234 FOX RIDGE ROAD ROANOKE VA 24018 DISQUALIFICATION 5/24/2017



85






EXPIRATION DATE

PIOTROWSKI, DENISE CHHA 4/24/1971 100 EAST MAIN STREET MARLTON NJ 08053 DEBARMENT 7/31/2017PIRLAMARLA, JYOTI MD 12/30/1950 1952349425 77 JACKSON MILLS ROAD FREEHOLD NJ 07728 DISQUALIFICATION 9/21/2016PIRMISASHVILI, TEA CHHA 8/16/1976 43 LINDEN STREET FORDS NJ 08863 DISQUALIFICATION 2/20/2017PIROVOLOS, NICHOLAS RPH 1/10/1930 30 DWIGHT DRIVE WEST DEAL NJ 07712 DISQUALIFICATION 9/16/2000PIROVOLOS, NICHOLAS RPH 1/10/1930 30 DWIGHT DRIVE OCEAN NJ 07712 SUSPENSION 10/20/2002PISANI, LOUIS RPH 7/19/1951 1215250709 2 E. FRANKLIN COURT GARDEN CITY NY 11530 SUSPENSION 10/19/2000PISANI, LOUIS RPH 7/19/1951 1215250709 PO BOX 737513 ELMHURST NY 11373 DISQUALIFICATION 6/3/2016PIUCK, CHARLOTTE L. MD 7/22/1922 593 RAMAPO VALLEY ROAD OAKLAND NJ 07436 DISQUALIFICATION 10/25/2001

PIZZARELLI, ANGELA D. 6/19/1981 1111 BOND STREET ASBURY PARK NJ 07712 DISQUALIFICATION 7/18/2001PLANT, CHINIA 1/20/1980 2013 LOGAN STREET HARRISBURG PA 17102 DISQUALIFICATION 11/20/2015PLINIO, STEVEN DC 5/20/1966 655 AMBOY AVENUE WOODBRIDGE NJ 07095 DEBARMENT 9/30/1999 DECEASEDPLOTNIK, PYOTR MD 2/15/1944 1407019813 276 COLERIDGE STREET BROOKLYN NY 11235 DEBARMENT 5/23/2000PLOTTS, LISA AKA LISA RN 4/15/1976 111 BEECHWOOD AVENUE OAKLYN NJ 08107 SUSPENSION 10/18/2001PLUCINSKI, PATRICIA LPN 8/11/1964 201 HAEGELE PLACE MOUNT ROYAL NJ 08061 SUSPENSION 12/20/2009POBER, JOSEPH MD 8/29/1953 1194948703 126 LINDEN STREET RIDGEWOOD NJ 07450 DEBARMENT 12/14/2019POET, ALBERT MD 6/10/1949 1134270903 EAST BAY AVENUE MANAHAWKIN NJ 08050 DISQUALIFICATION 8/10/2007POFF, SHIABON LPN 7/31/1979 48 CHESTNUT STREET WARETOWN NJ 08758 DISQUALIFICATION 8/22/2017POGGIOLI, STEPHAN 5/11/1963 431 ACADEMY TERRACE LINDEN NJ 07036 SUSPENSION 6/18/2004POH-EIKOM, VICKI 9/8/1953 619A BILLINGS AVENUE PAULSBORO NJ 08062 DEBARMENT 12/29/1999POH-EIKOM, VICKI 9/8/1953 619A BILLINGS AVENUE PAULSBORO NJ 08062 DEBARMENT 1/11/2000POINTE O'WOODS 999 US HIGHWAY ROUTE 9 HOWELL NJ 07731 DISQUALIFICATION 7/11/2000POLANSKY, IRVING RPH 2/5/1926 260 MAIN STREET KEANSBURG NJ 07734 DISQUALIFICATION 7/9/1985POLISE, VINCENZO RPH 11/26/1973 33 HARRISON ROAD KINNELON NJ 07405 DEBARMENT 12/31/2015POLISHUK, ANDRIJ 9/1/1953 649 PULHAM COURT #A MANCHESTER NJ 08759 SUSPENSION 3/8/2008POLLACK, EARL T. DMD 12/16/1930 171 N. LANSDOWNE AVENUE LANSDOWNE PA 19050 DISQUALIFICATION 11/7/1986POLLACK, JOSEPH DPM 11/23/1906 PO BOX 11401 YARDVILLE NJ 08628 DISQUALIFICATION 9/30/1982 9/30/1987POLLEN, PHILIP C. MD 9/1/1954 1245341924 245 ROUTE 9 MORGANVILLE NJ 07751 DEBARMENT 10/28/2013POOLE, JAMES RN 4/29/1977 1639367972 34 SOUTH 2ND STREET, APT. DEQUESNE PA 15110 DISQUALIFICATION 11/20/2015POOLE, KENDRA CHHA 9/6/1985 222 COOLIDGE AVENUE TRENTON NJ 08618 DISQUALIFICATION 1/23/2018POPICK, ALAN DO 1/23/1948 1194789214 1532 CREEKSIDE ROAD WHITEHALL PA 18052 DISQUALIFICATION 2/11/2016POROGER, EMMA DO 5/27/1955 1669572368 59 LINWOOD ROAD STATEN ISLAND NY 10308 DISQUALIFICATION 5/12/2016POSNER, ROBERT S. DDS 6/21/1957 1740518992 53 WESTFIELD AVENUE CLARK NJ 07066 DISQUALIFICATION 6/23/1999POTACCO, PHILIP DC 5/6/1952 54 CHURCH STREET SOUTH ORANGE NJ 07079 SUSPENSION 2/20/2003



86






EXPIRATION DATE

POTTER, DIANE LPN 4/7/1968 215 FAIRFIELD LANE KING WILLIAM VA 23086 DISQUALIFICATION 5/20/2009POWELL, WILLIE MFT 2130 MILLBURN AVENUE MAPLEWOOD NJ 07040 DISQUALIFICATION 9/12/2016 PERMANENTPRAVETZ, MICHAEL MD 3/20/1949 531 GATES STREET PHILADELPHIA PA 19128 DEBARMENT 3/5/2001PRECISE MEDICAL LAB., 1265 PATERSON PLANK SECAUCUS NJ 07094 DISQUALIFICATION 12/1/1998PRENSKY, JOSHUA DMD 6/19/1976 1578761961 28-10 HIGH STREET FAIRLAWN NJ 07410 DISQUALIFICATION 7/17/2009PRENSKY, JOSHUA DMD 6/19/1976 1578761961 28-10 HIGH STREET BERGEN NJ 07410 DISQUALIFICATION 5/29/2013PRESILLA, ALEJANDRO MD 6/11/1948 1902835747 15 FULTON STREET WEEHAWKEN NJ 07086 DEBARMENT 4/30/2010 4/30/2013PRESS, STUART M. MD 3/29/1952 1525 E. PUTNAM AVENUE OLD GREENWICH CT 06870 DISQUALIFICATION 8/1/2009PRINTZ, BRUCE I. DO 11/28/1952 400 GILL LANE ISELIN NJ 08830 SUSPENSION 6/6/2004PRITCHARD, JOSEPH 11/24/1955 69 TALLWOOD DRIVE MEDFORD NJ 08055 SUSPENSION 5/9/2002 12/10/2014

PROSKUROVSKY, BORIS 3/27/1947 218 HALSEY STREET NEWARK NJ 07102 DISQUALIFICATION 8/4/1997PROSKUROVSKY, BORIS 3/27/1947 218 HALSEY STREET NEWARK NJ 07102 SUSPENSION 8/25/1998PROTAS, OLEG CHHA 9/6/1987 407 LIBERTY LANE MARLTON NJ 08053 DISQUALIFICATION 7/26/2017PROVOST, LAURIE LPN 2/26/1960 10 BALTIMORE BOULEVARD SEA GIRT NJ 08750 SUSPENSION 1/24/2014

PRZADOWSKA-KOKINDA, ELIZABETH M.

RN 6/13/1978 1106 PARKSIDE AVENUE TRENTON NJ 08618 SUSPENSION 4/20/2005

PUCCI, BRIAN M. RPH 4/6/1958 14 RAND ROAD PINE BROOK NJ 07058 SUSPENSION 9/20/2005 9/19/2014PUENTES, ELENA CHHA 11/28/1960 374B HAMILTON STREET SOMERSET NJ 08873 SUSPENSION 5/14/2007PUGLIESE, GIROLAMO MD 2/20/1922 103 MAIN STREET KEYPORT NJ 07735 SUSPENSION 2/22/1999 DECEASEDPUIG, TAYLOR CHHA 9/23/1994 21 OVERVIEW COURT, APT. BAYVILLE NJ 08721 DISQUALIFICATION 3/16/2021PUIG, TAYLOR PHARM

TECH9/23/1994 21 OVERVIEW COURT, APT.

21BAYVILLE NJ 08721 DISQUALIFICATION 3/23/2021

PULVIRENTI, FRANCESCA CHHA 4/21/1979 212 8TH STREET SURF CITY NJ 08008 SUSPENSION 9/29/2005PURNESS, TIFFANY CHHA 8/11/1990 105 BLACKWOOD-

CLEMONTON ROAD #704LINDENWOLD NJ 08021 DISQUALIFICATION 4/26/2018

QAYYUM, ABDUL RPH 12/2/1949 960 COUNTRY CLUB DRIVE TEANECK NJ 07666 SUSPENSION 4/27/2000

QUARTARARO, LOUIS MD 1/16/1968 1467460089 37 WEST CENTURY ROAD PARAMUS NJ 07652 DISQUALIFICATION 4/5/2019QUEEN, RYSHAUN CHHA 5/20/1992 6 KINGSBURY SQUARE, APT TRENTON NJ 08611 DISQUALIFICATION 7/10/2018QUEST, BRITTANY CHHA 8/27/1989 379 SANFORD AVENUE NEWARK NJ 07106 DISQUALIFICATION 2/8/2017



87






EXPIRATION DATE

QUICK SCRIPT PHARMACY 90 WASHINGTON STREET EAST ORANGE NJ 07017 SUSPENSION 9/22/2000QUIJADA, CARLOS COUNSE 3/27/1980 106 SPRING VALLEY AVENUE, HACKENSACK NJ 07601 DISQUALIFICATION 12/20/2012 4/9/2019QUILES, SHALITZA AKA CHHA 10/17/1985 1 WILLIS PLACE, APT. 5 KEANSBURG NJ 07734 DISQUALIFICATION 4/10/2019QUINN, JOHN, C. RN 1/19/1959 437 HARRISTOWN ROAD GLEN ROCK NJ 07452 SUSPENSION 6/20/2006QUINONES, ANEL 11/1/1960 48 GRAND STREET GARFIELD NJ 07026 DISQUALIFICATION 9/11/2001QUINONES, ELIZABETH CHHA 5/17/1969 210 BOND STREET ELIZABETH NJ 07206 DISQUALIFICATION 2/8/2017QURESHI, SHAMS MD 4/19/1950 1194743377 1084 MAIN AVENUE CLIFTON NJ 07011 DEBARMENT 1/27/2012R & M CORPORATION 156 COUNTRY FARM ROAD MARLTON NJ 08053 DISQUALIFICATIONRAAB, TERRI A. LPN 7/18/1960 3 MILL ROAD JAMESBURG NJ 08831 SUSPENSION 1/20/2004RABAH, MOHAMMAD DMD 11/30/1978 1669684114 55 ENCLOSURE STREET NUTLEY NJ 07030 DEBARMENT 3/3/2017 8/23/2019RADICS JR., ALEXANDER LPN 5/17/1961 13 WHITE HAVEN PLACE BLOOMINGDALE NJ 07403 DISQUALIFICATION 4/30/2019 PERMANENTRADOWITZ, MARK A. DC 9/2/1959 76 CHICHESTER ROAD MONROE TOWNSHIP NJ 08831 DISQUALIFICATION 9/4/2007RAFLA, MAGDY 10/19/1953 3 KULESSA COURT EAST BRUNSWICK NJ 08816 DEBARMENT 8/22/2011RAHMAN, RONALD MD 5/3/1950 1437378502 20 SUSSEX AVENUE VOORHEES NJ 08043 DISQUALIFICATION 5/29/2013RAHMAN, SAHID CHHA 1/8/1985 29 ROBIN COURT PISCATAWAY NJ 08854 DISQUALIFICATION 1/29/2018RAIA, JOSEPH MD 7/11/1959 1225126717 56 GRAFTON AVENUE NEWARK NJ 07104 DEBARMENT 7/28/2014RAJA, ABDUL H. 8/4/1947 53 FULHAN LANE HOLBROOK NY 11741 DISQUALIFICATION 1/29/2003RAJU, SRINIVASA RPH 9/5/1971 115 RIVERWALK WAY D2 CLIFTON NJ 07014 DISQUALIFICATION 7/20/2017RAMACHANDRA, MD 5/1/1952 1235219809 741 ROUTE 18 S. EAST BRUNSWICK NJ 08816 DEBARMENT 4/18/2014 11/5/2018RAMACHANDRA, MD 5/1/1952 1235219809 165 SALEM ROAD NORTH BRUNSWICK NJ 08902 DISQUALIFICATION 12/21/2020 RAMACHANDRA, MD 5/10/1952 1235219809 120 AMBERLY DR, UNIT K MANALAPAN NJ 07726 DISQUALIFICATION 7/20/2021 PERMANENTRAMANADHAM, ARUNA R.

MD 1/7/1946 1609157692 9 MOUNTAINVIEW DRIVE LIVINGSTON NJ 07039 DEBARMENT 1/12/2000

RAMAS, EDWIN L. LPN 5/18/1956 789 MITCHEL AVENUE UNION NJ 07083 DEBARMENT 7/17/2009 7/17/2014RAMIREZ, MARIELA CHHA 5/15/1961 775 EAST 3RD AVENUE, APT. ROSELLE NJ 07203 DEBARMENT 1/9/2018RAMOS, JEANETTE CHHA 8/24/1989 234 WILMONT AVENUE CAMDEN NJ 08105 DISQUALIFICATION 5/2/2017RAMOS, REYNALDO 12/22/1968 52 ABINGTON COURT MAYS LANDING NJ 08330 DEBARMENT 8/12/2013RAMOS, ROLANDO 5/13/1977 85 SHERMAN AVENUE TEANECK NJ 07666 DISQUALIFICATION 2/20/2004RAMPERSAD, LAKSHMINARINE

8/20/1953 11 APPLETREE LANE LANDING NJ 07850 SUSPENSION 12/20/2000

RANCOCAS VALLEY 700 ROUTE 130 NORTH CINNAMINSON NJ 08077 SUSPENSION 8/20/2003RAND, DOV MD 2/10/1965 1043311145 667 EAGLE ROCK AVENUE WEST ORANGE NJ 07052 SUSPENSION 2/15/2012RAND, DOV MD 2/10/1965 1043311145 667 EAGLE ROCK AVENUE WEST ORANGE NJ 07052 DEBARMENT 9/3/2013RAND, DOV MD 2/10/1965 1043311145 840 STONEWALL COURT FRANKLIN LAKES NJ 07417 DEBARMENT 5/7/2014



88






EXPIRATION DATE

RAND, ELIAS 11/5/1932 1401 OCEAN AVENUE BROOKLYN NY 11230 DISQUALIFICATION 6/1/1993RAO, MALINI MD 4/26/1975 1649456005 444 WASHINGTON JERSEY CITY NJ 07310 DISQUALIFICATION 9/12/2016RASCHID, SOHAEL MD 1/12/1957 1104851369 1126 KENNEBEC DRIVE CHAMBERSBURG PA 17201 DISQUALIFICATION 11/20/2015RASNER, STEVEN DMD 7/15/1954 1114022803 1055 NORTH PEARL STREET BRIDGETON NJ 08401 DISQUALIFICATION 10/16/1984 4/5/2018RASOULINEJAD, ZAHREH T.

DDS PO BOX 1217 ALPINE NJ 07620 SUSPENSION 10/20/2003

RATCHFORD, WILLIAM B. MD 2/13/1945 PO BOX 2063 GLENVIEW IL 60025 SUSPENSION 6/4/1998RAUH - BRIGHAM, SUSAN RN 8/24/1956 4 BRECKENRIDGE DRIVE SHAMONG NJ 08088 SUSPENSION 5/20/2001RAVAL, KAWU 600 PAVONIA AVENUE JERSEY CITY NJ 07306 SUSPENSION 12/1/1998RAVIN, JOHN M. MD 7/29/1938 9600 STERLING RIDGE

AVENUELAS VEGAS NV 89129 SUSPENSION 2/19/2004

RAY, DEBRA RN 5/14/1952 32 KAYWIN AVENUE HAWTHORNE NJ 07506 SUSPENSION 2/19/2004RAYNOR, MARCELLA 8/27/1952 660 BROAD STREET, APT. 811 HARRISBURG PA 17102 DISQUALIFICATION 11/20/2015RAZIQ, RAFIK 1/1/1960 NORTHERN STATE PRISON NEWARK NJ 07115 DISQUALIFICATION 7/1/2002REA, MICHAEL MD 444 MANSFIELD AVENUE HADDONFIELD NJ 08033 DEBARMENT 3/11/2001 DECEASEDREATH, ERIN R. RN 10/3/1960 7705 SABRE DRIVE KNOXVILLE TN 37919 SUSPENSION 8/18/2005REAVES, LORI A. MD 12/4/1960 1417959503 ALDERSON FPC, GLEN RAY

RD, BOX AALDERSON WV 24910 DISQUALIFICATION 3/7/2014

REBA, GARY J. DDS 2/17/1947 1285852541 TITUS LANE PLAINSBORO NJ 08536 SUSPENSION 12/20/2007RECK, FRANZ DDS 1/16/1963 1528248457 17 CENTER STREET HIGHLANDS NJ 07732 DISQUALIFICATION 12/1/2019 7/21/2020RECOVERY SYSTEMS INC. 476 CLIFTON AVENUE CLIFTON NJ 07011 SUSPENSION 5/8/2003REDDEN, DAYJA CHHA 8/1/1989 1822 SOUTH 7TH STREET CAMDEN NJ 08104 DISQUALIFICATION 1/23/2018REDDY, PRANATHI DMD 8/24/1976 1538321583 6207 SPRUCE MILL DRIVE MORRISVILLE PA 19067 DISQUALIFICATION 1/23/2019 7/21/2020REDNOR, GERALD B. 101 KENSINGTON AVENUE TRENTON NJ 08618 DISQUALIFICATION 6/1/1993REDONDO, ILEANA MD 6/4/1932 2421 ROSETTE STREET FORT LEE NJ 07024 DISQUALIFICATION 4/23/2002REED, JUDY 233A MUHAMMAD ALI

AVENUENEWARK NJ 07108 DISQUALIFICATION 12/15/2005

REED, STEPHAN NILS DC 7/14/1942 4722 EAST DELL ROAD PHOENIX AZ 85026 DISQUALIFICATION 6/1/1993 DECEASEDREEVES, WILBURN C. CNA 5/19/1971 23 CREEK ROAD BRICK NJ 08724 DISQUALIFICATION 8/10/2007REFOCUS GROUP, LLC 1306342373 200 ROUND HILL DRIVE FREEHOLD NJ 07728 SUSPENSION 4/29/2019REGO, RAMON MD 11/13/1961 1033227459 6701 BERGENLINE AVENUE WEST NEW YORK NJ 07093 DEBARMENT 3/19/2012 2/16/2017REHAN, ZAHEER A. 280 HENDERSON STREET JERSEY CITY NJ 07302 DISQUALIFICATION 5/10/1999REHMAN, FAROOQ MD 1/25/1954 1467581827 225 MAY STREET, SUITE D-1 EDISON NJ 08837 SUSPENSION 4/20/2016 2/9/2017



89






EXPIRATION DATE

REHMAN, FAROOQ MD 1/25/1954 1467581827 225 MAY STREET, SUITE D-1 EDISON NJ 08837 DEBARMENT 11/13/2015 REID, PEACHES CNA 11 RUTGERS STREET IRVINGTON NJ 07111 DISQUALIFICATION 4/1/2002REINHARD, BARBARA 704 REED COURT FLEMINGTON NJ 08822 DISQUALIFICATION 7/9/2007REINHART, JENNIFER LPN 8/1/1977 70 ROSS AVENUE HACKENSACK NJ 07601 DISQUALIFICATION 11/23/2019REITER, RAYMOND D. MD 1/21/1955 1841447380 405 MURRAY HILL PARKWAY,

#1023EAST RUTHERFORD NJ 07073 DISQUALIFICATION 10/22/2001

RENNER, ALLISON 1/27/1977 1210 OAK ROAD MANASQUAN NJ 08736 DISQUALIFICATION 3/28/2017RENNER, CARL MD 3/13/1952 1346205705 61 WALDRON AVENUE GLEN ROCK NJ 07452 DISQUALIFICATION 6/25/2019 PERMANENTRENZI, CAROLINE M. DO 3/4/1922 247 CENTER STREET TRENTON NJ 08611 DISQUALIFICATION 12/4/1991 DECEASEDRESTORATION 1385 STUYVESANT AVENUE UNION NJ 07083 DEBARMENT 1/16/2009 1/6/2012REVAN-LEWIS, CHAUNDEL CHHA 2/6/1981 26 NANCY LANE PISCATAWAY NJ 08854 DISQUALIFICATION 2/8/2017REYES, BRIANNA CHHA 5/29/1991 220 WEST BRANCH AVENUE, PINE HILL NJ 08021 DISQUALIFICATION 3/5/2019REYES, DANNIELL DC 4/21/1960 1124053905 5262 HAMILTON S SAYLORSBURG PA 18353 DISQUALIFICATION 11/20/2015REYES, MARIA CHHA 6/13/1987 1207 ATLANTIC AVENUE CAMDEN NJ 08104 DEBARMENT 8/29/2017REYES-ARIAS, ARCADIO 1/12/1971 286 SUSSEX AVENUE NEWARK NJ 07107 DISQUALIFICATION 2/11/2016REZNIKOVA, YELENA CHHA 9/28/1977 73 MADISON GARDENS OLD BRIDGE NJ 08857 DEBARMENT 6/12/2017RGN PHARMACY 1790840130 22 ELIZABETH AVENUE NEWARK NJ 07108 SUSPENSION 8/17/2007RHODES, SARE MAE DMD 2/6/1978 1750572996 161 BRIDGE STREET TUNKHANNOCK PA 18657 DISQUALIFICATION 12/29/2015RIACHI, LABIB MD 9/4/1968 1801846597 319 MASSACHUSETTS WESTFIELD NJ 07090 DISQUALIFICATION 2/9/2017RIACHI, LABIB MD 9/4/1968 1801846597 42 RUTGERS AVENUE COLONIA NJ 07067 DEBARMENT 2/9/2018RICCIARDI, JUDE CHHA 12/6/1969 1452 45TH STREET NORTH BERGEN NJ 07047 SUSPENSION 6/20/2002RICCIO, PETER RPH 4/16/1953 17 CASALE DRIVE, APT. R2 WARREN NJ 07059 DISQUALIFICATION 5/12/2016RICH, LEO CEDAR LANE TEANECK NJ 07666 DISQUALIFICATION 6/1/1993RICHARDS, AARON COUSEL

OR12/14/1962 23 WYCOFF STREET DEAL NJ 07723 SUSPENSION 2/20/2001

RICHARDSON, YALONDA CHHA 7/15/1980 52 2ND AVENUE TOMS RIVER NJ 08757 DISQUALIFICATION 2/20/2017

RICHLINE, AMANNDA DPM 5/5/1969 1013040435 4 GREENWICH STREET BELVIDERE NJ 07823 DEBARMENT 7/22/2017RICHMAN, HOWARD P. DPM 12/31/1951 502 N BLACK HORSE PIKE WILLIAMSTOWN NJ 08053 DISQUALIFICATION 4/15/1993RICHSTONE, GEOFFREY MD 9/17/1938 PO BOX 38, FCI FORT DIX NJ 08640 SUSPENSION 6/20/2002RIGGI, JOSEPH MD 8/5/1970 1265436638 36 VARDON WAY FARMINGDALE NJ 07727 DEBARMENT 12/9/2015 4/9/2019RIGO, BLADIMIR 3/22/1940 FCI-FORT DIX, PO BOX 2000 JOINT BASE MDL NJ 08640 DISQUALIFICATION 5/12/2016RILEY, BRIDGETT PHARM 1801 EGG HARBOR ROAD LINDENWOLD NJ 08021 SUSPENSION 3/20/2003RIMERMAN, VALERY MD 4/29/1939 43 DEMAREST AVENUE CLOSTER NJ 07624 SUSPENSION 12/20/2006 DECEASED



90






EXPIRATION DATE

RIOS, GUSTAVO ERNESTO MD 9/13/1967 1780648295 127 TWEED DRIVE JACKSONVILLE NC 28540 DEBARMENT 10/11/2011RIOS, JOSE MD 8/22/1927 175 SUMMER AVENUE NEWARK NJ 07104 SUSPENSION 5/14/1998RIPPS, DANIEL DDS 9/3/1948 1124293659 1330 CALHOUN STREET TRENTON NJ 08618 DISQUALIFICATION 12/1/1995RIVERA, DAISY CHHA 10/20/1994 329 LINE STREET CAMDEN NJ 08103 DISQUALIFICATION 1/29/2018RIVERA, JACQUELINE CHHA 6/11/1977 418 12TH STREET, APT. #1 UNION CITY NJ 07087 DISQUALIFICATION 1/23/2018RIVERA, JOSSELIN 9/14/1979 251 MT. VERNON STREET CAMDEN NJ 08103 DISQUALIFICATION 1/27/2006RIVERA, KAREN CHHA 9/23/1989 209 NILES STREET, APT. 1 ELIZABETH NJ 07202 DEBARMENT 2/20/2017RIVERA, MARIA RN 11/1/1948 39 JOHNS WAY BRIDGETON NJ 08302 DISQUALIFICATION 9/30/2019RIVERA, NICOLE AKA RN 2/11/1983 2009 KICKAPOO TERRACE VINELAND NJ 08361 DISQUALIFICATION 3/28/2017RIVERA, VIVIANIS CHHA 7/5/1984 519 BRUNSWICK AVENUE TRENTON NJ 08638 DISQUALIFICATION 10/20/2017RIZVI, SAIYID PHD 100 CRAIG ROAD, SUITE 104 MANALAPAN NJ 07726 SUSPENSION 4/18/1997RIZZO, KENNETH RPH 2/16/1965 110 WELLS FARM ROAD GOSHEN NY 10924 SUSPENSION 5/19/2005RIZZUTO, MARY F. LCSW 1/24/1960 1851499891 16 HOLLY HILL DRIVE TOMS RIVER NJ 08753 DISQUALIFICATION 4/22/2012ROBACK, MARY LPN 7/29/1954 2517 DUNKSFERRY ROAD, BENSALEM PA 19020 DISQUALIFICATION 6/20/2018ROBALINO, JOFFRE MD 6/12/1967 1770634404 PO BOX 1000 CUMBERLAND MD 21501 DISQUALIFICATION 5/28/2013ROBBERSON JR., 8/17/1969 3404 SHORELINE DRIVE WALL TOWNSHIP NJ 07719 DISQUALIFICATION 6/16/2017ROBBINS, GORDON J. 447 UNION AVENUE PATERSON NJ 07522 DISQUALIFICATION 4/30/1987ROBBINS, RICHARD G. MD 7/29/1963 551 MILLBURN AVENUE SHORT HILLS NJ 07078 SUSPENSION 2/19/2004ROBERTS, ELIANE CHHA 9/10/1962 380 PARK AVENUE, APT. C5 ORANGE NJ 07050 DISQUALIFICATION 7/14/2017ROBERTS, JAMES RN 5/29/1969 235 PENN AVENUE DOVER NJ 07801 DISQUALIFICATION 7/22/2017ROBERTSON, TANAYE CHHA 8/11/1987 1200 EAST STATE STREET,

APT. 1405CAMDEN NJ 08105 DISQUALIFICATION 7/10/2018

ROBINSON, CHRISTINA CHHA 2/10/1993 81 ABBLETT VILLAGE CAMDEN NJ 08105 DISQUALIFICATION 7/22/2019ROBINSON, KIM 2/23/1956 594 WALNUT STREET ELIZABETH NJ 07201 SUSPENSION 2/3/2003ROBINSON, TRENNAJIA CHHA 2/18/1994 89 FOURTH STREET, APT. #43 PASSAIC NJ 07055 DISQUALIFICATION 5/2/2017ROBINSON, VINCENT 3/10/1968 62 MAPLE AVENUE IRVINGTON NJ 07111 DEBARMENT 3/13/2009 3/13/2014ROBINSON, WANDA J. 7/23/1944 150 MELROSE AVENUE IRVINGTON NJ 07111 DISQUALIFICATION 9/4/1986RODENBERG, THOMAS MD 4/6/1959 1720280183 DESOTO ANNEX, 13617 ARCADIA FL 34266 DISQUALIFICATION 12/29/2015RODRIGUEZ, ARACELY CHHA 4/18/1975 1039 NORTH 35TH STREET CAMDEN NJ 08105 DEBARMENT 5/31/2018RODRIGUEZ, BEATRIZ 10/8/1967 109 GREENBRIAR AVENUE RICHLAND NJ 08350 SUSPENSION 10/18/2001RODRIGUEZ, CHRISTIAN CHHA 8/10/1982 2 W. PARK AVENUE PENNS GROVE NJ 08069 DISQUALIFICATION 3/5/2019RODRIGUEZ, DARIELI CHHA 5/22/1991 545 NEWTON LAKE DRIVE COLLINGSWOOD NJ 08107 DISQUALIFICATION 9/26/2017RODRIGUEZ, FERNANDO MD 6/10/1950 122 S. MONTFORT DRIVE BELLE MEAD NJ 08502 DEBARMENT 4/6/2004RODRIGUEZ, JAZMIN CHHA 7/28/1987 214 48TH STREET UNION CITY NJ 07087 DISQUALIFICATION 7/10/2018



91






EXPIRATION DATE

RODRIGUEZ, LEONELA CHHA 2/21/1990 1032 N. 21ST STREET CAMDEN NJ 08105 DEBARMENT 7/10/2018RODRIGUEZ, MELENYS CHHA 6/26/1990 18 WINDING WOOD DRIVE SAYREVILLE NJ 08872 DISQUALIFICATION 8/29/2017RODRIGUEZ, NICOLE CHHA 10/13/1992 658 DELSEA DRIVE PITMAN NJ 08071 DEBARMENT 4/6/2018RODRIGUEZ, RAMON R. 1/13/1939 100 MANHATTAN AVENUE JERSEY CITY NJ 07307 DISQUALIFICATION 3/17/1986 DECEASEDRODRIGUEZ, RONALD J. LPN 5/20/1966 7 EASTERN LANE WILLINGBORO NJ 08046 SUSPENSION 12/20/2006RODRIGUEZ, RONALD J. LPN 5/20/1966 7 EASTERN LANE WILLINGBORO NJ 08046 DEBARMENT 7/11/2018ROGERS, JAMES G. 2/22/1937 49 WESTERN PARKWAY IRVINGTON NJ 07111 SUSPENSION 4/11/2006ROHAUS, ROBERT 301 LILAC COURT BRIDGEWATER NJ 08807 SUSPENSION 8/25/2000ROHE, PAUL DPM 11/16/1956 24 FAIRWAY DRIVE GREEN BROOK NJ 08812 SUSPENSION 11/20/2006ROLON JR., ORLANDO 11/4/1957 1239 DUPONT STREET CAMDEN NJ 08105 DISQUALIFICATION 11/12/2009ROMANAZZI, THOMAS 612 MYRTLE AVENUE MANASQUAN NJ 08786 DISQUALIFICATIONROMAN-CISSE, DENISE PHARM 12/16/1983 9 SECOND AVENUE NEWARK NJ 07104 DEBARMENT 4/12/2012ROMANOWSKI, STEVEN PO BOX 1011 UNION NJ 07083 DISQUALIFICATION 6/1/1985ROMERO, IVAN J. RPH 4/14/1969 1003089343 USP CANAAN, PO BOX 300 WAYMART PA 18472 DISQUALIFICATION 8/8/2011ROMILLO, JOSE E. MD 3/1/1945 1467544155 954 FISCHER BOULEVARD TOMS RIVER NJ 08753 DISQUALIFICATION 8/16/2011RONAN, KATHLEEN RN 17 HENRY STREET SAYERVILLE NJ 08872 SUSPENSION 10/18/2001RONCAL JR., MARIO 4/2/1951 901 RIFLE CAMP ROAD WOODLAND PARK NJ 07424 DISQUALIFICATION 8/20/2014RONE, FELICIA CHHA 3/19/1978 2702 SHETLAND WAY WESTVILLE NJ 08093 DISQUALIFICATION 7/14/2017ROQUE, JOSE RAMON MD 317 60TH STREET WEST NEW YORK NJ 07903 DISQUALIFICATION 8/1/1996ROSA, EDDIE MD 3/3/1966 1215045869 796 MOUNT PROSPECT NEWARK NJ 07104 SUSPENSION 2/15/2012ROSA, EDDIE MD 3/3/1966 1215045869 117-119 THIRD AVENUE 2 NEWARK NJ 07104 DISQUALIFICATION 1/26/2015ROSA, EDDIE MD 3/3/1966 1215045869 117-119 THIRD AVENUE NEWARK NJ 07104 DEBARMENT 11/21/2016ROSA, EDDIE MD 3/3/1966 1215045869 796 MOUNT PROSPECT NEWARK NJ 07104 DISQUALIFICATION 9/17/2013ROSADO, EDITH CHHA 10/29/1968 326 GREGORY AVENUE PASSAIC NJ 07055 DISQUALIFICATION 2/8/2017ROSANIA, NICHOLAS G. DC 5/28/1968 1 COBBLESTONE LANE LONG VALLEY NJ 07853 SUSPENSION 10/20/2003ROSARIO, JASON CHHA 2/10/1993 133 RUTGERS PLACE NUTLEY NJ 07110 DEBARMENT 11/1/2017ROSE, RADCLIFFE RN/PHA 8/10/1965 99 GROVE AVENUE MAYWOOD NJ 07607 DISQUALIFICATION 2/21/2018 PERMANENTROSEN, BURTON DDS 9/22/1930 1939 ROUTE 70 EAST CHERRY HILL NJ 08003 DEBARMENT 5/24/1999ROSEN, JAY MD 11/30/1946 1720139736 3 HIDDEN ACRES DRIVE VOORHEES NJ 08043 DISQUALIFICATION 8/22/2016 PERMANENTROSENBERG, MARK RN/APN 4/3/1954 1407829096 19 BRANDYWINE DRIVE MARLTON NJ 08052 DISQUALIFICATION 11/21/2016ROSENBLIT, ERIN RN/APN 8/17/1955 654 8TH STREET ABSECON NJ 08201 DEBARMENT 6/5/2018ROSENFARB, ANDREW ACCUPU 1/12/1972 332 SOUTH AVENUE EAST WESTFIELD NJ 07090 SUSPENSION 3/20/2005ROSENSWEET, MARTIN DPM 6/27/1957 FORT DIX FCI, PO BOX 38 JOINT BASE MDL NJ 08640 DEBARMENT 7/18/2002ROSERO, BENITO MD 11/18/1937 107 E. MANTUA AVENUE WEHONAH NJ 08090 SUSPENSION 2/2/1998



92






EXPIRATION DATE

ROSERO, BENITO MD 11/18/1937 109 AMBLER ROAD CHERRY HILL NJ 08002 SUSPENSION 1/6/1999ROSS, BERNARD MD 5/8/1914 30 E. PASSAIC STREET MAYWOOD NJ 07607 DEBARMENT 10/5/1999ROSS, DOUGLAS AKA SHAW, RICKY

12/10/1972 123 N. 19TH STREET EAST ORANGE NJ 07017 DISQUALIFICATION 10/14/2005

ROSS, JONATHAN MD 4/1/1954 11 TEAK COURT CHERRY HILL NJ 08003 DISQUALIFICATION 6/19/2000ROSS, JOSIE B. RN 6/27/1955 25 GRAND AVENUE HACKENSACK NJ 07601 SUSPENSION 7/20/2004ROSS, RUBY LPN 10/15/1964 149 RIDGE AVENUE ASBURY PARK NJ 07712 DISQUALIFICATION 12/5/2017ROSSI, ANGELA LPN 12/18/1976 813 HAZELTON AVENUE LANOKA HARBOR NJ 08734 DISQUALIFICATION 6/5/2017ROSSNICK, GERALD DDS 1/29/1923 868 BROADWAY BAYONNE NJ 07002 DISQUALIFICATION 12/1/1988ROTHENBERG, HOWARD DMD 4/14/1951 1437223898 11 OAK SPRING ROAD WEST NYACK NY 10994 DISQUALIFICATION 12/29/2017ROTHSTEIN, JEFFREY DMD 12/4/1964 1366677544 326 BROAD STREET, SUITE 1 RED BANK NJ 07701 DISQUALIFICATION 7/20/2017 9/22/2017

ROTWEIN, PAUL S. DDS 6/24/1957 220 E. 63RD STREET, APT. 8F NEW YORK NY 10021 DEBARMENT 4/20/2003ROUNTSEV, ANATOLI CHHA 3/25/1962 409 RIVERVIEW DRIVE TOTOWA NJ 07512 SUSPENSION 11/4/2014ROUNTSEV, ANATOLI CHHA 3/25/1962 406 RIVERVIEW DRIVE TOTOWA NJ 07512 DISQUALIFICATION 2/11/2016ROUSE, JODY LPN 9/2/1977 189 BROWNIES ROAD SHIPPENVILLE PA 16254 DISQUALIFICATION 11/20/2015ROUSSIS, NICHOLAS MD 6/29/1968 1497749089 4735 HYLAN BOULEVARD STATEN ISLAND NY 10312 DEBARMENT 7/1/2017ROWE, ELIZABETH LPN 4/10/1982 6 WINDING WOOD DRIVE, SAYREVILLE NJ 08872 DEBARMENT 6/28/2018ROYSTER, TAHNESHA CHHA 4/15/1988 30 RIDGE AVENUE NEPTUNE NJ 07753 DEBARMENT 8/24/2017ROZO, GLADYS 374B HAMILTON STREET SOMERSET NJ 08873 SUSPENSION 5/14/2007ROZVAGA, NADEZHDA 11/4/1946 155 ALEXAUKEN CREEK

ROADLAMBERTVILLE NJ 08530 SUSPENSION 8/20/2009

RUANE, JOSEPH T. DC 8/16/1955 314 WILLOW DRIVE LITTLE SILVER NJ 07739 SUSPENSION 1/8/1997RUBBANI, MARIAM MD 2/28/1972 1801939723 280 SOUTH HARRISON EAST ORANGE NJ 07017 DISQUALIFICATION 9/12/2018RUBINSTEIN, CHARLES RPH 45 LAUREL AVENUE LINWOOD NJ 08221 SUSPENSION 8/20/2006RUCHELMAN, TRINA DDS 1/19/1973 1356425474 2120 ROUTE 70 MANCHESTER NJ 08759 DISQUALIFICATION 5/20/2019RUDOLPH, HERBERT MD 11/9/1954 1871633370 317 EAST MAIN STREET TUCKERTON NJ 08087 DEBARMENT 9/14/2016 2/19/2020RUFFIN, SHARALYN CHHA 12/12/1980 OAKDALE VILLAGE TRAILER

#52CRANBURY NJ 08512 DISQUALIFICATION 2/8/2017

RUGGIERO, PAULA E. RN 12/8/1970 29 PARKWAY DRIVE WESTVILLE NJ 08093 SUSPENSION 10/18/2001RUIZ, DORIS 909 WEST 7TH STREET PLAINFIELD NJ 07063 SUSPENSION 5/14/2007RUIZ, JENNIFER 4/14/1983 38 S. BRIDGEBORO STREET DELRAN NJ 08075 DISQUALIFICATION 11/21/2016RULDAN, THOMAS LPN 301 OHIO AVENUE PHILLIPSBURG NJ 08865 SUSPENSION 5/20/2001RUMMA, CHRISTINE 164 STARBOARD STREET FORKED RIVER NJ 08731 DISQUALIFICATION 5/26/2000



93






EXPIRATION DATE

RUSH, DALE LPN 6/20/1962 182 PRESTON ROAD, APT. H2 MILFORD NJ 08848 DISQUALIFICATION 3/11/2019

RUSH, DAVID A. 6/25/1959 5755 PFEIFER CIRCLE GERMANSVILLE PA 18053 SUSPENSION 4/19/1999RUSH, DAVID A. 6/25/1959 5755 PFEIFER CIRCLE GERMANSVILLE PA 18053 DISQUALIFICATION 10/11/2000RUSHING, GARY DC 5/20/1959 1538315478 70 BROAD STREET, SUITE B MATAWAN NJ 07747 SUSPENSION 1/20/2002RUSSELL JR., BERTRAM R. MD USP HAZELTON, PO BOX BRUCETON MILLS WV 26525 DEBARMENT 12/28/2014RUSSELL, FERNESE D. CNA 666 E. 26TH STREET PATERSON NJ 07504 DEBARMENT 3/24/2002RUSSELL, ROBERT J. DC 3/26/1962 1645 B-BLACKWOOD BLACKWOOD NJ 08012 DISQUALIFICATION 10/2/1995RUSSO, GRACE RN 5/4/1960 17 MAPLE PLACE KEYPORT NJ 07735 DISQUALIFICATION 9/30/2019RUSSOMANNO, MD 5/30/1943 1093702532 350 BLOOMFIELD AVENUE BLOOMFIELD NJ 07003 DEBARMENT 11/28/2007RUTA, EUGENIO DC 4/14/1961 189 6TH AVENUE LONG BRANCH NJ 07740 SUSPENSION 7/21/2008RUTIGLIANO, MICHAEL MD 3/23/1962 1740348077 1 SEARS DRIVE PARAMUS NJ 07652 DISQUALIFICATION 9/19/2016RX 2000 PHARMACY, INC. 2125A KENNEDY BOULEVARD JERSEY CITY NJ 07305 DISQUALIFICATION 1/2/2000

RYAN, GERALDINE RN 2/5/1956 228 RIDGE AVENUE LAKEWOOD NJ 08701 SUSPENSION 2/20/2002RYAN, JAMES 267 SEACLIFF AVENUE SEACLIFF NY 11579 DISQUALIFICATION 4/1/1996 4/1/2004RYAN, MICHELE K. LPN 7/25/1969 656 WHITE HORSE PIKE HAMMONTON NJ 08037 SUSPENSION 3/20/2002RYBALOV, SEMEN CHHA 11/5/1945 BERGEN COUNTY JAIL, PO HACKENSACK NJ 07601 DISQUALIFICATION 10/28/2015RYTEL, SYLVIA LPN 5/1/1983 634 INDIANA AVENUE TRENTON NJ 08638 DISQUALIFICATION 8/3/2019S. RESES APOTHOCARY 6522 VENTNOR AVENUE VENTNOR NJ 08406 DISQUALIFICATIONSAA, SHALITZA AKA CHHA 10/17/1985 1 WILLIS PLACE, APT. 5 KEANSBURG NJ 07734 DISQUALIFICATION 4/10/2019SAADY, JACK R. RPH 7/18/1960 281 ROUND HILL DRIVE FREEHOLD NJ 07728 DISQUALIFICATION 7/11/2000SABA - KHALIL, ROSALY MD 10/10/1939 531 SUMMIT AVENUE FRANKLIN LAKES NJ 07417 DISQUALIFICATION 7/10/1995SABATE, NEONITA RN 6/3/1956 PO BOX 4004 CLINTON NJ 08809 DISQUALIFICATION 8/27/2001SABBAGHZADEH, ANDREW A.

9/29/1981 108 BRANDON ROAD EAST SYRACUSE NY 13057 SUSPENSION 3/20/2012

SABIDO, BENJAMIN A. MD 3/30/1952 1720159916 805 11TH STREET UNION CITY NJ 07087 DISQUALIFICATION 3/26/2015SACCA, COLLEEN RN 11/11/1969 310 GARFIELD AVENUE PALMYRA NJ 08065 SUSPENSION 5/20/2004SACHER, PHILIP 558 ANDERSON AVENUE CLIFFSIDE PARK NJ 07010 DISQUALIFICATION 5/6/1986SADARANGANI, MD 7/12/1945 1386790665 240 LYNCREST ROAD ENGLEWOOD CLIFF NJ 07632 DISQUALIFICATION 2/28/2011SADLER, RUFUS MD 3/13/1956 1316935406 2 LAWRENCE STREET MOUNT VERNON NY 10552 DISQUALIFICATION 6/3/2016SAEED, MOHAMMED PHARM 1507 FINNEGANS LANE NEW BRUNSWICK NJ 08902 DISQUALIFICATION 11/16/1998SAFIER, GARY DO 2/21/1943 1558478529 8 QUARRY COURT, #3 RANDOLPH NJ 07869 DEBARMENT 4/1/2016



94






EXPIRATION DATE

SALAAM, ABDUL J. MD 1153 SOUTH ORANGE NEWARK NJ 07103 DISQUALIFICATION 8/7/1997SALAGA, JENNIFER RN 3/29/1981 248 WARD AVENUE BORDENTOWN NJ 08505 DISQUALIFICATION 6/28/2017SALAMI, ADEMOLA T. HARVARD AVENUE HILLSIDE NJ 07205 DISQUALIFICATION 9/15/2008SALARTASH, KHASHAYAR MD 8/11/1966 1457376006 112 POND LANE LINWOOD NJ 08221 SUSPENSION 10/27/2009 10/7/2011SALEMA, JOSEPH 4/25/1948 101 EAST ELM STREET WENONAH NJ 08090 DISQUALIFICATION 4/4/1998SALITA, CONRAD C. MD 4/27/1932 1 N. VALLEY AVENUE VINELAND NJ 08360 DISQUALIFICATION 12/29/1995SALKIND, SCOTT A. DO 8/10/1953 1750401949 611 KINGS CROFT CHERRY HILL NJ 08034 SUSPENSION 9/14/2000SALOMONE, JOSEPH DC 3/11/1968 1609019140 156 FRANKLIN AVENUE NUTLEY NJ 07110 DISQUALIFICATION 7/20/2015SALT & PEPPER INC. 24 BRANFORD PLACE NEWARK NJ 07102 DISQUALIFICATION 5/9/1994SALUJA, DHANBIR MD 8/8/1941 1023045010 230 JEFFERSON STREET NEWARK NJ 07105 DEBARMENT 8/24/2013SALUJA, DHANBIR MD 8/8/1941 1023045010 230 JEFFERSON STREET NEWARK NJ 07105 DISQUALIFICATION 6/3/2016SALVATORE JR., THOMAS 201 HAMILTON AVENUE TRENTON NJ 08609 DISQUALIFICATIONSAMAN, AIAD L. 47 CENTER PLACE STATEN ISLAND NY 10306 DISQUALIFICATION 3/25/2009SAMI, ASHRAF 64 CARUTH AVENUE, APT. 66 ELMWOOD PARK NJ 07407 DISQUALIFICATION 5/24/2017

SAMILLAN, HANS CHHA 8/22/1984 3-3 SYDNEY WAY LONG BRANCH NJ 07740 DISQUALIFICATION 2/8/2017SAMUEL, DELORIS PO BOX 4004 CLINTON NJ 08809 DISQUALIFICATION 5/2/2008SANCHEZ, MAURICE 243 PROSPECT AVENUE NORTH ARLINGTON NJ 07031 DISQUALIFICATION 1/1/2011 4/30/2012SANCHEZ, MELISSA CHHA 1/7/1983 45 FRANKLIN PLACE TOTOWA NJ 07512 DISQUALIFICATION 7/10/2018SANDERLIN, KATHLEEN RN 4/16/1960 824 SANIKAN TRAIL SOUTHAMPTON NJ 08088 SUSPENSION 10/18/2001SANDERS, DENISE PHARM 3/21/1953 4 DREXEL COURT LINDENWOLD NJ 08021 DISQUALIFICATION 7/12/1995SANDERS, MICHAEL THERAPI 8/29/1964 4 CHERRY ROAD NEWTON NJ 07860 SUSPENSION 10/19/2006SANDERSON, LYNN LPN/RN 7/8/1956 120 GATES MILL COURT TRENTON NJ 08690 SUSPENSION 6/20/2005SANDFORD'S PHARMACY 128 MAIN STREET MATAWAN NJ 07747 DISQUALIFICATION 1/5/1999SANDIEGO, NARDO MD 10/26/1935 1578508115 4 HEATHER HILL LANE SUFFERN NY 10901 DEBARMENT 10/8/2013SANGALANG, ALEX RN 9/18/1955 21 LISA DRIVE HAZLET NJ 07730 DISQUALIFICATION 6/5/2017SANGHERA, ANIL MD 1/14/1950 105 PHEASANT FIELD LANE MOORESTOWN NJ 08057 DISQUALIFICATION 5/20/2009SANICO, ELAINE D. DPM 122 BRIGHT STREET, #1W JERSEY CITY NJ 07302 SUSPENSION 11/19/1997SANTA MARIA, DONNA L. RN 7/3/1954 618 CINDER ROAD EDISON NJ 08820 DISQUALIFICATION 7/18/2001SANTANA, SONIA CHHA 5/27/1939 569 E. 33RD STREET PATERSON NJ 07613 DISQUALIFICATION 3/28/2001SANTANGELO, FRANK MD 10/4/1969 1881785293 705 HAMBURG TURNPIKE WAYNE NJ 07470 DISQUALIFICATION 11/22/2016SANTANGELO, FRANK MD 10/4/1969 1881785293 705 HAMBURG TURNPIKE WAYNE NJ 07470 DISQUALIFICATION 3/13/2017SANTANIELLO, RICHARD J. 3/3/1970 5 BUGLE COURT HOWELL NJ 07731 SUSPENSION 3/20/2002SANTIAGO JR., EDDIE MD 9/2/1969 1497796973 300 SECOND AVENUE LONG BRANCH NJ 07740 DISQUALIFICATION 11/1/2014 8/22/2019



95






EXPIRATION DATE

SANTIAGO, HEDBERTO CNA 9/29/1983 3265 S. US HIGHWAY 1, LOT FORT PIERCE NJ 34982 DISQUALIFICATION 9/12/2020SANTIAGO, RANALDO GIBBSBORO ROAD LINDENWOLD NJ 08021 DISQUALIFICATION 8/10/2007SANTIAGO, REYNALDO MD 3/8/1945 1502A MARCY PLACE PHILADELPHIA PA 19115 DISQUALIFICATION 6/16/1997SANTIAGO, RUTH M. CHHA 2/1/1967 289 BROADWAY, APT. E NEWARK NJ 07104 SUSPENSION 7/19/2001SANTIAGO, VANESSA 35 AMHERST ROAD SOUTH TOMS RIVER NJ 08757 DEBARMENT 5/31/2006SANTIAGO-JIMINEZ, 4/12/1955 396 WOODLAND AVENUE SOUTH AMBOY NJ 08879 DISQUALIFICATION 9/19/2011SANTOS - ARIAS, SIMON MD 10/28/1941 1497721062 10305 NW 7TH COURT PLANTATION FL 33324 DEBARMENT 8/18/2016SANTOS, YESTEL CHHA 7/19/1992 9 WESLEY COURT MOUNT HOLLY NJ 08060 DISQUALIFICATION 7/10/2018SAPERSTEIN, ALAN 1538270525 30 HIGHLAND ROAD DIX HILLS NY 11746 DISQUALIFICATION 3/1/1987SARKODIE, ALEX MD 7/27/1960 1598870271 516 YORKTOWN ROAD UNION NJ 07083 DISQUALIFICATION 9/14/2016SARKODIE, ALEX MD 7/27/1960 1598870271 516 YORKTOWN ROAD UNION NJ 07083 DISQUALIFICATION 6/5/2017SARVAIYA, RAMESH MD 8/6/1954 1578558748 26 EASTWOOD DRIVE VOORHEES NJ 08043 DISQUALIFICATION 5/14/2021SATCHER, WILLIAM 558 ANDERSON AVENUE CLIFFSIDE PARK NJ 07010 DISQUALIFICATIONSAUCHELLI, FRANCIS MD 10/31/1954 1124586326/1 151 BLOOMFIELD AVENUE, VERONA NJ 07044 DEBARMENT 9/13/2019SAUL, STEPHEN L. DPM 4/2/1971 76 W. JIMMIE LEEDS ROAD ABSECON NJ 08201 DISQUALIFICATION 7/18/2001 PERMANENTSAUL, STEPHEN L. DPM 4/2/1971 9 SEASIDE COURT MARGATE CITY NJ 08402 DISQUALIFICATION 9/12/2016 PERMANENTSAVINO, THOMAS MD 2/5/1959 1821087305 65 BUTTONWOOD ROAD STATEN ISLAND NY 10304 DISQUALIFICATION 8/10/2018SAVINO, THOMAS MD 2/5/1959 1821087305 FCI FORT DIX, PO BOX 2000 JOINT BASE MDL NJ 08640 DISQUALIFICATION 5/18/2019SAYED, SAQUIB MD 9/14/1965 1609054360 4 TURTLE HOLLOW COURT SICKLERVILLE NJ 08081 DEBARMENT 4/29/2016

SAYED-BAKHATY, ABDEL MD 5/4/1954 403 HARMON TOWERS SECAUCUS NJ 07094 SUSPENSION 4/26/1995SAYEGH, RICKY MD 4/1/1975 1346274966 4 FOWLER AVENUE YONKERS NY 10701 DISQUALIFICATION 9/19/2016SAYEGH, RICKY MD 4/1/1975 1346274966 390 FORT HILL ROAD SCARSDALE NY 10583 DEBARMENT 11/20/2017SBARRA, SAMUEL DC 9/3/1958 1205913100 PARK AVENUE NUTLEY NJ 07110 SUSPENSION 10/20/2008 1/20/2015SCARPITTA, JANET 9/2/1964 92 PEABODY PLACE NEWARK NJ 07104 DISQUALIFICATION 6/15/2001SCERBO, ERNEST J. MD 10/9/1909 26-10 BROADWAY SUITE 103 FAIR LAWN NJ 07410 DISQUALIFICATION 6/1/1993 DECEASED

SCHECHTER, MARVIN OD 1063420453 100 YORKTOWN DRIVE MOUNT LAUREL NJ 08054 DISQUALIFICATION 6/1/1993SCHEIN, HERBERT W. MD 2/22/1917 1027 HOOPER AVENUE TOMS RIVER NJ 08753 DISQUALIFICATION 5/30/1991 DECEASEDSCHEINER, DAVE E. DPM 12/14/1950 910 BONAPARTE COURT PHILADELPHIA PA 19107 SUSPENSION 7/22/1999SCHENKEL, CATHERINE RN 10/6/1956 87 IRVING AVENUE, APT. 3 LIVINGSTON NJ 07039 DISQUALIFICATION 6/20/2009SCHENKEL, CATHERINE MICHELLE

RN 10/6/1956 87 IRVING AVENUE, APT. 3 LIVINGSTON NJ 07039 SUSPENSION 5/30/2010



96






EXPIRATION DATE

SCHERING SALES CORPORATION

2000 GALLOPING HILLS ROAD KENILWORTH NJ 07033 SUSPENSION 10/20/2005

SCHLACHTER, ANDREA 1/19/1971 42 WEST HOLLY STREET CRANFORD NJ 07016 SUSPENSION 11/20/2006SCHLEMBACH, ANDREA AKA OLIVER, ANDREA

APN/RN 7/26/1979 1780630418 70 COHANSEY STREET BRIDGETON NJ 08302 DISQUALIFICATION 9/12/2016 5/21/2020

SCHLISSERMAN, HERMAN 300 48TH STREET UNION CITY NJ 07087 DISQUALIFICATION

SCHMIDT, NORINE RN 7/15/1959 78 S. ROOSEVELT SQUARE ENGLEWOOD NJ 07631 DISQUALIFICATION 7/12/2018SCHMOLK, DERRICK RN 9/22/1989 11 BEVIS LANE CAPE MAY NJ 08210 DISQUALIFICATION 2/25/2019SCHMUCKER-KARPOW, CELESTE

RPH 4/6/1954 50 MAPLE AVENUE MORRISTOWN NJ 07960 DISQUALIFICATION 12/27/1995 DECEASED

SCHNEIDER, BRUCE J. DDS 11/1/1951 520 CLIFFORD AVENUE, E8 MATAWAN NJ 07747 SUSPENSION 7/20/2006SCHNORBUS PHARMACY 351 NORTH WARREN STREET TRENTON NJ 08618 DISQUALIFICATION 8/19/1981SCHOBERT III, WILLIAM B. 25 WELLINGTON DRIVE, #D LUMBERTON NJ 08048 DISQUALIFICATION 6/20/2009 7/14/2014

SCHRAGER, KENNETH, J. MD FCI OTISVILLE, PO BOX 600 OTISVILLE NY 10963 SUSPENSION 6/19/2001SCHROEDER, PETER RN 6/17/1968 18 PILGRIM WAY HAMILTON NJ 08620 DISQUALIFICATION 10/11/2017SCHULTZ, STEVEN MD 9/16/1946 1495 EAST 92ND STREET, #2 BROOKLYN NY 11236 DISQUALIFICATION 6/9/1999SCHUTT, CHARLES 21 PARMLEY ROAD TINTON FALLS NJ 07724 DISQUALIFICATION 3/8/1978SCHWARTZ, EDWARD RPH 3/5/1936 60 SIP AVENUE JERSEY CITY NJ 07306 DISQUALIFICATION 8/6/1998 SCHWARTZ, EDWARD RPH 3/5/1936 720 HARMON COVE TOWERS SECAUCUS NJ 07094 DISQUALIFICATION 1/17/2001 SCHWARTZ, EDWARD RPH 3/5/1936 1021 HERALD STREET REDLANDS CA 92374 SUSPENSION 12/20/2000 SCHWARTZ, GEORGE ROBERT

MD 1/2/1942 PO BOX 1806 SANTA FE NM 87504 SUSPENSION 12/19/2007

SCHWARTZ, JADE LPN 11/16/1983 97 SHORELAND CIRCLE SOUTH AMBOY NJ 08879 DISQUALIFICATION 8/21/2018SCHWARTZ, MARK MD 8/1/1966 1164436325 308 CHELSEA MANOR PARK RIDGE NJ 07656 DEBARMENT 11/16/2018SCHWARTZ, MURRAY DO 9/5/1943 1063573012 5 AUTUMN COURT CHERRY HILL NJ 08003 DEBARMENT 1/23/2013 SCHWARTZ, MURRAY DO 9/5/1943 1063573012 5 AUTUMN COURT CHERRY HILL NJ 08003 DISQUALIFICATION 12/5/2013SCHWARZ, DENISE DPM 1729 PAMMEL PARK ROAD WINTERSET IA 50273 SUSPENSION 2/20/2002SCOPELLITI, ALDO R. DC 9/5/1958 1568524049 107 MONMOUTH ROAD WEST LONG BRANCH NJ 07764 SUSPENSION 5/12/2000SCOTT, DEBRA 1/3/1964 2751 S. OCEAN DRIVE HOLLYWOOD FL 33019 SUSPENSION 5/20/2004SCOTT, GLENN RN 10/8/1961 70 POLIFLY ROAD, APT. 105 HACKENSACK NJ 07601 SUSPENSION 10/18/2001SCOTT, MARVELL MD 2/28/1973 1144417478 41 FIDDLERS WAY SPARTA NJ 07871 DEBARMENT 8/12/2020



97






EXPIRATION DATE

SCOTT, MCKENZIE LPN 5/22/1986 457 REDBANK ROAD TEMPLETON PA 16259 DISQUALIFICATION 11/20/2015SCOTT, MELVIN 11/9/1974 42 HIGHLAND TERRACE IRVINGTON NJ 07111 SUSPENSION 6/3/2001SCULLION, FRANCES RN 20 BREAKNECK ROAD OAKLAND NJ 07436 DISQUALIFICATION 7/13/1988SCURRY, MARSHAYA PHARM 1/15/1983 1500 GARDEN DRIVE OCEAN NJ 07712 DEBARMENT 1/4/2017 6/26/2018SEAMAN, VIVIAN RN 4/6/1960 823 TENTH STREET UNION BEACH NJ 07735 DISQUALIFICATION 9/12/2016SEDEHI, AHMAD DMD 6/15/1949 1063634640 31 JANE DRIVE ENGLEWOOD CLIFFS NJ 07632 DEBARMENT 7/1/2017SEGLIN, MARK PSYCH 7/11/1944 1184754632 89 LAPIS CIRCLE WEST ORANGE NJ 07052 DISQUALIFICATION 1/1/2017SEHGAL, GAUTAM MD 12/20/1949 1497801740 8 WINDERMERE COURT LIVINGSTON NJ 07039 SUSPENSION 5/2/2016SEHGAL, SHASHIBALA MD 12/27/1949 630 FORT WASHINGTON NEW YORK NY 10040 SUSPENSION 12/31/2000 10/17/2018SELIM, HANAN RPH 9/7/1968 47 NORWOOD AVENUE CLIFTON NJ 07011 SUSPENSION 5/30/2000SEMPLE, IVRY 724 GROVE STREET IRVINGTON NJ 07111 DISQUALIFICATION 12/24/1985SEMPLE, IVRY 472 LAKESIDE AVENUE ORANGE NJ 07050 DISQUALIFICATION 8/14/1986SENAPE, SAVERIO MD 1/1/1940 215 WEST 92ND STREET, 15A NEW YORK NY 10025 DISQUALIFICATION 8/5/1998SENATORE, SALVATORE DC 2/19/1949 1073653366 342 LINCOLN DRIVE KENILWORTH NJ 07033 DISQUALIFICATION 8/19/2010SENDER, PAUL MD 3/7/1955 1124321286 30A WEST MAPLE AVENUE MONSEY NY 10952 SUSPENSION 11/20/2006 12/22/2014SENQUIZ, LUZ COUNSE 9/26/1951 471 HIGHLAND AVENUE, COLLINGSWOOD NJ 08108 SUSPENSION 4/29/2003SENTILLES, JEAN J. MD 11/27/1945 150 W 56TH STREET N 509 NEW YORK NY 10019 DISQUALIFICATION 2/27/1992SEPAHBODY, CYRUS DDS 3/23/1967 1487706305 507 SUMMERFIELD AVENUE, ASBURY PARK NJ 07712 DISQUALIFICATION 5/18/2019SERENO, PATRICIA LPN/RN 7/27/1950 18 SECRETARIAT STREET HOWELL NJ 07731 SUSPENSION 9/20/2001SERPE, JOSEPH RN 9/20/1988 459 MAIN STREET STATEN ISLAND NY 10307 DISQUALIFICATION 6/5/2017SERRANO, KRISTINA CHHA 9/26/1995 59 ARCADIA PLACE, #B VINELAND NJ 08360 DISQUALIFICATION 2/8/2017SESAY, CHERYL LPN 11/2/1959 12 AVA AVENUE SOMERDALE NJ 08083 SUSPENSION 10/20/2002SESSOMS, VALERIE 12/16/1958 29 STRATFORD PLACE, APT. NEWARK NJ 07108 DISQUALIFICATION 9/20/2012SEUFERT, ANNA MARIE CHHA 5/8/1990 5139 LAKE WORTH ROAD GREEN ACRES FL 33463 DISQUALIFICATION 6/19/2014SEXTON, JILL RN 1/8/1978 5460 ROUTE 100 PLYMOUTH VT 05056 DISQUALIFICATION 9/12/2016SHACK, DANIEL RPH 2/4/1958 2 GRACEHILL COURT TITUSVILLE NJ 08560 SUSPENSION 9/20/2006SHAH, JAYEN C. MD 5/15/1952 MEADOWLANDS PARKWAY SECAUCUS NJ 07096 DISQUALIFICATION 7/26/1996SHAHINE, AYMAN MD 8/15/1963 1235341850 334 86TH STREET BROOKLYN NY 10024 DISQUALIFICATION 4/1/2019SHAKARJIAN, CARNIG C. DPM 5/9/1962 1720007743 99 KINDERKAMACK ROAD EMERSON NJ 07630 DEBARMENT 6/25/2013

SHARIF, MUDASSAR MD 3/27/1970 1366509903 308 MOUNTAIN ROAD BASKING RIDGE NJ 07920 DEBARMENT 12/16/2015SHARIM, IRADJ MD 7/20/1942 1790739423/1 1208 BIRCH AVENUE YARDLEY PA 19067 DISQUALIFICATION 8/14/2020 PERMANENTSHARMA, RAVINDER MD 2/18/1953 1306947999 3 MARTIN COURT MARTINSVILLE NJ 08836 DEBARMENT 1/22/2016 1/3/2019SHARMA, YOGENDRA P. OD 8/1/1944 17 VAHLSING WAY ROBBINSVILLE NJ 08691 DEBARMENT 2/28/2000



98






EXPIRATION DATE

SHAROW, RALPH DMD 11/19/1945 1679670038 PO BOX 1000- CAMP FORT DIX NJ 08640 SUSPENSION 7/20/2003SHAW, RICKY AKA ROSS, 12/10/1972 123 N. 19TH STREET EAST ORANGE NJ 07017 DISQUALIFICATION 10/14/2005SHEA, ANN M. RN 12/28/1973 706-08 ZLOTKIN CIRCLE FREEHOLD NJ 07728 SUSPENSION 10/18/2001SHEIKH, IMTIAZ A. MD 2/20/1945 1008 BRAINARD PLACE BRIELLE NJ 08730 DISQUALIFICATION 12/1/1998SHEIKH, MOHAMMAD 7/9/1953 59-07 71ST AVENUE RIDGEWOOD NY 11385 DEBARMENT 10/20/2003SHEIKH, NAFEESA 3/11/1957 516 BLOOMFIELD AVENUE NUTLEY NJ 07110 SUSPENSION 11/20/2003SHERANI, TAHIR S. 5/7/1965 215 N. WYOMING STREET SOUTH ORANGE NJ 07079 DISQUALIFICATION 2/7/2000SHERMAN, HENRY M. MD 4/20/1942 1922334457 141 S. HARRISON STREET EAST ORANGE NJ 07018 DISQUALIFICATION 2/5/1997 12/14/2011SHIELDS, HEATHER LPN 5/2/1973 100 ROLLING ACRES SLIPPERY ROCK PA 16057 DISQUALIFICATION 11/20/2015SHIPMAN, BRYAN LEE 2/9/1973 1210 CHERSONESE ROUND MOUNT PLEASANT SC 29464 DISQUALIFICATION 3/20/2012SHKLOVER, TOBIAS MD 5/14/1955 2611 W. 2ND STREET BROOKLYN NY 11223 SUSPENSION 9/20/2007SHMIDMAN-HOROWITZ, 5/8/1930 8215 ABINGDON ROAD KEW GARDENS NY 11478 DISQUALIFICATIONSHRAMOWIAT, MICHAEL MD 10/28/1952 1568485233 1158 46TH STREET, APT A VIENNA WV 26105 DISQUALIFICATION 5/14/2021

SHROPE, CATHY L. 5/30/1967 175 COUNTY ROUTE 519 S. BELVIDERE NJ 07823 DISQUALIFICATION 7/22/2002SHROUT, WILLIAM 3/22/1960 PO BOX 280 FAIRTON NJ 08320 SUSPENSION 9/20/2001SHTINDLER, EDUARD 7/14/1983 150 CUMBERLAND COURT PARAMUS NJ 07093 SUSPENSION 9/30/2019SHULMAN, JONATHAN RN 12/18/1976 11945 NE 19TH DRIVE, APT. 1 NORTH MIAMI FL 33181 DISQUALIFICATION 5/18/2019SHUSTER, LARRY B. RPH 1/2/1953 3136 GUILFORD STREET PHILADELPHIA PA 19152 SUSPENSION 3/9/2008 6/26/2017SIAM, NABIL A. MD 67 HIGHWAY 37, PO BOX 193 TOMS RIVER NJ 08754 DEBARMENT 12/1/1999SIBERT, SCOTT L. MD 43 WOODLAND AVENUE WOODBURY NJ 08096 DISQUALIFICATION 11/15/1985 DECEASEDSIDDIQUI, AFTAB A. MD 12/25/1932 1073527545 504 LIVINGSTON STREET NORWOOD NJ 07648 SUSPENSION 6/19/1998SIDDIQUI, NURUL HASAN 4/19/1948 4912 BERGENLINE AVENUE WEST NEW YORK NJ 07093 DISQUALIFICATION 1/12/1996

SIDDIQUI, SHAKIR H. 5/14/1947 619 SCHUYLER AVENUE KEARNY NJ 07032 SUSPENSION 3/10/1998SIDDIQUI, SHOAIB H. 6/25/1953 9 TOWER DRIVE EAST HANOVER NJ 07936 SUSPENSION 7/19/2001SIEGEL, JONATHAN B. DPM 11/30/1959 4772 HIGHWAY 9 SOUTH HOWELL NJ 07731 DISQUALIFICATION 9/11/2000SIGLE, EDWARD 10/2/1925 CRANBURY SOUTH RIVER MONROE TOWNSHIP NJ 08831 DISQUALIFICATION 5/29/2007SILMAN, ALEX DDS 4/7/1975 1629319751 3 CLARK PLACE MARLBORO NJ 07746 SUSPENSION 10/22/2010 1/5/2018SILVA, SANDY COUNSE

LOR2208 HILLCREST AVENUE PENNSAUKEN NJ 08110 SUSPENSION 4/29/2003

SILVERHARDT, STEPHEN DDS 1881821403 1436 MARSHALL LANE MEADOWBROOK PA 19046 DISQUALIFICATION 2/16/1988SILVERMAN, HAROLD 529 BROAD STREET NEWARK NJ 07102 DISQUALIFICATION



99






EXPIRATION DATE

SIMMONS, SHAMEKIA RIDGE AVENUE ASBURY PARK NJ 07712 SUSPENSION 8/21/2008SIMONE, RENEE CRIVELLO RPH 7/1/1977 403 SCOTT COURT UNION NJ 07083 SUSPENSION 10/22/2010

SIMONETH, A'DAYJA CHHA 6/14/1995 711 CEDAR STREET LAKEHURST NJ 08753 DISQUALIFICATION 4/18/2017SINGER-ANDREINI 5532 BERGENLINE AVENUE WEST NEW YORK NJ 07093 SUSPENSION 7/23/1998SINGH, MANJIT MD 4/19/1943 21 LEHMAN STREET MAHWAH NJ 07430 SUSPENSION 2/24/1998SINGH, MANJIT MD 4/19/1943 12 HARRISON MOUNT LAKE RINGWOOD NJ 07456 SUSPENSION 11/24/2007SINGH, PRITPAUL MD 3/5/1948 1164717807 9 KINBERLY COURT VOORHEES NJ 08043 DISQUALIFICATION 4/27/2021 PERMANENTSINGH, SAGGOO MD 3/19/1947 485 S. DOBSON ROAD, STE.

202CHANDLER AZ 85224 SUSPENSION 11/20/1995

SINGH, SURINDER MD 4/2/1951 288 SUMMIT AVENUE JERSEY CITY NJ 07306 DISQUALIFICATION 7/23/2007SINGLETON, RUSSELL DMD 5/28/1962 1912166133 401 BROADWAY CAMDEN NJ 08103 DISQUALIFICATION 8/9/2014 1/10/2018SINGLETON, WANDRA LPN 6/12/1970 86 MELROSE AVENUE IRVINGTON NJ 07111 DISQUALIFICATION 6/5/2017SINHA, BINOD P. MD 7/26/1951 1932201662 3 HELENE AVENUE EDISON NJ 08820 DISQUALIFICATION 3/3/2017 PERMANENTSINHA, BINOD P. MD 7/26/1951 1932201662 3 HELENE AVENUE EDISON NJ 08820 DISQUALIFICATION 12/6/2017 PERMANENTSINVANY-NUBEL, AVIVA RN/APN 683 DONALD DRIVE NORTH BRIDGEWATER NJ 08807 SUSPENSION 10/20/2005SIRIPURAPU, PADMA MD 5/12/1967 1710061056 201 LYONS AVENUE NEWARK NJ 07112 SUSPENSION 2/15/2012 12/3/2020SIRIPURAPU, PADMA MD 5/12/1967 1710061056 1 SCENIC HILLS COURT BELLE MEAD NJ 08502 DISQUALIFICATION 12/30/2014 12/3/2020SIROTA, ALEKSANDR 6/1/1970 PO BOX 2000 LEWISBURG PA 17837 DISQUALIFICATION 8/19/2010SISON, JOSEPH MD 6/19/1957 1730110149 41 BROWNSTON WAY STE ENGLEWOOD NJ 07631 SUSPENSION 8/2/2011SIVAKANTHA, PSYCH 11/14/1964 1114080165 PO BOX 5503 SOMERSET NJ 08875 DISQUALIFICATION 9/20/2011SKAGGS, MATTHEW A. 5/31/1972 2127 QUAETHEM DRIVE CHESTERFIELD MO 63005 DISQUALIFICATION 1/20/2012SKURATON, JEFFREY RPH 9/26/1943 WINGED FOOT DRIVE LIVINGSTON NJ 07039 SUSPENSION 6/19/2008SLAKIE, CHRISTINE RN 6/27/1961 103 EDGE LANE WILLINGBORO NJ 08046 SUSPENSION 9/19/2003SLATER, BARBARA A. LPN 7/28/1956 7 POINT ROAD TOMS RIVER NJ 08753 SUSPENSION 10/18/2001SLOAN, BARRY MD 6/21/1958 1770578262 1561 LEMOINE AVENUE FORT LEE NJ 07024 DISQUALIFICATION 7/31/2018SLOAN, DEBRA 8/16/1954 31 SCHAAF ROAD BLOOMSBURY NJ 08804 DEBARMENT 8/12/2012SLOTNICK, SINO 1556 RIVER ROAD TEANECK NJ 07666 DISQUALIFICATION 6/1/1993SLOVER, SHAYLA 12/15/1958 NORTH MAPLE AVENUE MARLTON NJ 08053 SUSPENSION 6/4/2007SMITH III, RUSSELL P. LPN 7/23/1955 33 ORCHARD AVENUE PENNINGTON NJ 08534 SUSPENSION 4/19/2007SMITH III, RUSSELL P. LPN 7/23/1955 714 S. PENNSYLVANIA MORRISVILLE PA 19067 DISQUALIFICATION 6/22/2007SMITH, ALPHONSO MD 2/17/1938 421 WESTWOOD DRIVE #U WOODBURY NJ 08096 SUSPENSION 7/31/2002

SMITH, CHARLES M. 11/5/1988 1825 67TH AVENUE PHILADELPHIA PA 19126 DISQUALIFICATION 11/20/2015



100






EXPIRATION DATE

SMITH, DWAYNE 1/1/1965 12-14 ELM STREET, APT. 6 MONTCLAIR NJ 07042 DISQUALIFICATION 9/23/2007SMITH, JENNIFER LYNN 11/19/1979 428 GLENWOOD AVENUE WILLIAMSPORT PA 17701 DISQUALIFICATION 11/20/2015SMITH, JOHANNA LPN 3/26/1982 1507 ATLANTIC AVENUE,

APT. 65MANASQUAN NJ 08736 DEBARMENT 11/27/2018

SMITH, KHALILAH LPN 3/11/1977 32 ELIZABETH STREET HACKENSACK NJ 07601 DISQUALIFICATION 11/27/2018SMITH, LAKESIA CHHA 5/4/1983 2030 RIVERSIDE DRIVE, APT. TRENTON NJ 08618 DISQUALIFICATION 2/20/2017SMITH, LARRY 9/9/1960 183 SOUTH HIGHLAND YORK PA 17404 DISQUALIFICATION 11/20/2015SMITH, LAURA LPN 10/5/1959 1051 OLD FREEHOLD ROAD TOMS RIVER NJ 08753 SUSPENSION 10/18/2007SMITH, MARK RPH 3/21/1977 1510 OCEAN PARKWAY #18F BROOKLYN NY 11230 DEBARMENT 1/27/2017SMITH, TAMMY CHHA 7/16/1980 203 LAKEVIEW BOULEVARD BROWNS MILLS NJ 08015 DISQUALIFICATION 2/8/2017SMITH, WILLIAM 6/3/1931 RT 1 35 WHITE TAIL ROAD SAN MARCOS TX 78666 DISQUALIFICATIONSMITH-DORSEY, JULIA RN 12/2/1969 37 WINFIELD DRIVE PARSIPPANY NJ 07054 DEBARMENT 8/2/2017 8/22/2019SMOLEV, JOSEPH M. MD 11/25/1909 158 HAMILTON AVENUE PASSAIC NJ 07055 DISQUALIFICATION 6/1/1993 DECEASEDSMOLIN, STEVE RPH 6/14/1949 1124184619 228 KINGS HIGHWAY BROOKLYN NY 11223 DISQUALIFICATION 9/7/2001SMUTEK, MICHELLE M. LPN 12/29/1968 2115 FLORENCE AVENUE HAZLET NJ 07735 DEBARMENT 10/20/2002SNELL, PHILIP MD 6/12/1915 217 PAULISON AVENUE PASSAIC NJ 07055 DISQUALIFICATION 6/1/1993SODANO, MICHAEL J. 9/10/1949 708 FOREPEAK AVENUE BEACHWOOD NJ 08722 DISQUALIFICATION 6/1/1993SODANO, MICHAEL J. 9/10/1949 708 FOREPEAK AVENUE BEACHWOOD NJ 08722 SUSPENSION 1/6/1999SOHN, YOUNG PSYCH 12/13/1932 63 CARLOUGH ROAD UPPER SADDLE RIVER NJ 07458 SUSPENSION 6/20/2000SOKHA, BORIS 7/26/1954 FCI FORT DIX JOINT BASE MDL NJ 08640 SUSPENSION 5/20/2009SOLARZ, LAUREN 7/1/1955 1133 THACKERY CIRCLE VOORHEES NJ 08043 SUSPENSION 7/19/1999SOLBERG, BYRNE MD 6/19/1953 1710996871 107 PENN STREET RIVERTON NJ 08077 DISQUALIFICATION 11/21/2018SOLBERG, BYRNE MD 6/19/1953 1710996871 103 FOXHALL LANE NARBERTH PA 19072 DISQUALIFICATION 11/20/2015SOLIMANDO, LISA LPN 5/17/1972 41 LONG VALLEY ROAD LODI NJ 07644 DISQUALIFICATION 3/28/2017SOLOMON, JENNIFER 10/22/1969 142 BROAD STREET NEWARK NJ 07104 DISQUALIFICATION 6/25/2002SOLOMON, MARCUS 7/2/1966 142 BROAD STREET NEWARK NJ 07104 DISQUALIFICATION 6/25/2002SOLOMONOV, MIKHAIL MD 1/26/1966 1225095672 9 HAMILTON DRIVE SOUTH NORTH CALDWELL NJ 07006 DISQUALIFICATION 10/17/2019SOMERSET, WILLARD RPH 1123 BROAD STREET NEWARK NJ 07114 DISQUALIFICATION 1/1/1988SONG, KI I. MD 4/20/1941 1720138936 62 COTTAGE STREET JERSEY CITY NJ 07306 SUSPENSION 4/7/2011SONG, YO-JUN MD 8/10/1945 1982657540 1857 DIAMOND HEALTH

DRIVECASTLE ROCK CO 80104 DISQUALIFICATION 8/28/2017 PERMANENT

SONG, YOUNG 37 DEANNA DRIVE EAST HANOVER NJ 07936 DISQUALIFICATION 7/19/2010 7/19/2015SONI, HARDIK MD 4/20/1975 1750498028 90 BEAUVOIR AVENUE SUMMIT NJ 07901 DISQUALIFICATION 7/22/2017SONZA, PATRICIO A. MD 3/17/1945 1316974850 8 CONSTITUTION WAY FLEMINGTON NJ 08822 SUSPENSION 11/20/2010



101






EXPIRATION DATE

SORBELLO, TANYA J. LPN 5/20/1969 460 NEW STREET EAST GLASSBORO NJ 08028 SUSPENSION 2/19/2004SORONGON, MARCELINO MD 4/26/1941 192 SURREY COURT RAMSEY NJ 07446 SUSPENSION 5/18/2000SOSTOWSKI, RICHARD M. MD 10/1/1947 1003038951 250-1 BROOK HOLLOW LANE BERNARDSVILLE NJ 07924 DEBARMENT 11/20/2014 5/16/2016

SOTO, GREGORIO 153 LEWIS STREET PERTH AMBOY NJ 08861 DEBARMENT 3/18/2015SOUTHERN MEDICAL & 2230 S. CROSKEY STREET PHILADELPHIA PA 19145 DISQUALIFICATION 4/19/1992SOUTHERN OCEAN PEDIATRICS AND FAMILY MEDICINE

1346664893 1100 ROUTE 72 WEST, SUITE 304

MANAHAWKIN NJ 08050 SUSPENSION 1/27/2017 4/27/2017

SOYFER, ALEXANDER 7/31/1955 655 AMBOY AVENUE WOODBRIDGE NJ 07095 DISQUALIFICATION 5/21/2002SOYFER, ALEXANDER 7/31/1955 104 MAPLE HILL DRIVE WOODBRIDGE NJ 07095 SUSPENSION 6/20/2001SPADARO, BREKKE AKA BEST, BREKKE

RN 6/10/1981 35 WOODROW AVENUE FRANKLIN LAKES NH 03235 DISQUALIFICATION 2/20/2018

SPAIN, ANTHONY B. DMD 5/12/1961 1437316098 113 CRESCENT AVENUE PLAINFIELD NJ 07060 DEBARMENT 5/28/2002SPANIER, CYNTHIA PSYCH 11/16/1958 530 BROOKDALE DRIVE PITTSBURGH PA 15215 DISQUALIFICATION 11/20/2015SPANO, ANTHONY THERAPI 6/30/1949 176 EVERGREEN STREET HILLSDALE NJ 07642 SUSPENSION 11/20/2003SPAVLIK, LAURIE R. 8/3/1968 200 EAST GRANT AVENUE SOMERDALE NJ 08083 SUSPENSION 4/19/2001SPECIALTY CLINICAL LABORATORY

299 ACADEMY STREET JERSEY CITY NJ 07306 DISQUALIFICATION 12/1/1998

SPEDALIERE, CARMINE MD 10/27/1923 1601 KENNEDY BOULEVARD NORTH BERGEN NJ 07407 DISQUALIFICATION 7/19/1999SPEKTOR, IOSIF G. MD 7/18/1941 1043340235 54 INDIAN DRIVE WOODCLIFF LAKE NJ 07675 SUSPENSION 9/20/2000SPIGNER, AKOSUA RPH 10/25/1960 941 LINCOLN AVENUE GLEN ROCK NJ 07452 DEBARMENT 5/15/2014 3/3/2020SPINAPOLICE, JOSEPH DO 4/7/1944 1063678670 811 WASHINGTON STREET PARLIN NJ 08859 DISQUALIFICATION 4/1/2016 PERMANENTSPINELLI, PAULA CHHA 4/7/1972 94 FAIR STREET HACKENSACK NJ 07601 DISQUALIFICATION 9/19/2017SPIVEY, DEBRA RN 9/30/1983 644 STUYVESANT AVENUE,

APT. 2TRENTON NJ 08611 DISQUALIFICATION 6/28/2017

SPLITTER, SAMUEL R. MD 4/24/1914 1742 MARYLAND AVENUE CAPE MAY NJ 08204 DISQUALIFICATION 5/4/1998SPYRIDON-MARKER, 25 ELKINTON ROAD ALLOWAY NJ 08001 DISQUALIFICATION 10/20/2002ST PETER, LISA 2/12/1964 PO BOX 2000 BRUCETON MILLS WV 26525 DEBARMENT 11/17/2008STANCH, JAMES M. PSYCH 10/13/1952 160 S. LAKESHORE DRIVE MANAHAWKIN NJ 08050 SUSPENSION 5/3/2006STANCH, JAMES M. PSYCH 10/13/1952 FCI PO BOX 350 BEAVER WV 25813 SUSPENSION 11/20/2008STANKO-STRACK, MARY RN 8/31/1962 1348 MILLENNIUM COURT TOMS RIVER NJ 08753 DISQUALIFICATION 5/20/2010STANLEY, JAMES R. 4/7/1959 FCI FORT DIX, PO BOX 38 FORT DIX NJ 08640 SUSPENSION 12/20/2001



102






EXPIRATION DATE

STANTON JR., FRANCIS X. MD 7/27/1954 1327 CAMINITO BATEA LA JOLLA CA 92037 DEBARMENT 10/18/2001STARKMAN, MOISHE MD 7/16/1959 1871609149 2206 YELLOWSTONE ROAD CINNAMINSON NJ 08077 DISQUALIFICATION 10/11/2017 PERMANENT

STATLINE AMBULANCE & PO BOX 2100 WEST PATERSON NJ 07424 DISQUALIFICATION 1/15/1987STAVCO, INC. 300 MAIN STREET AVON NJ 07717 DISQUALIFICATION 1/11/2005STAVITSKI, MICHAEL RPH 5/4/1963 419 FAWNS RUN MORGANVILLE NJ 07751 DISQUALIFICATION 7/12/2002STEEL, BURTON B. MD 8/25/1923 1 ROUND HILL ROAD WASHINGTONVILLE NY 10992 DISQUALIFICATION 6/14/1984 DECEASEDSTEELE, JESSICA RN 2/10/1991 8 SWEETBRIAR LANE LEVITTOWN PA 19055 DISQUALIFICATION 5/25/2019STEFANELLI, DANETTE DC 7/5/1967 1831245760 91 EAGLE ROCK AVENUE, ROSELAND NJ 07068 DISQUALIFICATION 10/28/2015STEFANELLI, LEONARD RPH 8/21/1964 1285958645 11 DOGWOOD LANE EAST HANOVER NJ 07936 DISQUALIFICATION 11/14/2014 PERMANENTSTEFANELLI, LEONARD RPH 8/21/1964 1285958645 11 DOGWOOD LANE EAST HANOVER NJ 07936 DISQUALIFICATION 3/29/2017 PERMANENTSTEFANELLI, LEONARD RPH 8/21/1964 1285958645 MDC BROOKLYN 80 29TH BROOKLYN NY 11232 DISQUALIFICATION 7/20/2015 PERMANENTSTEFFEN, H. PAUL 10/16/1947 4305 APPLE LANE PAULSBORO NJ 08066 SUSPENSION 9/20/2001STEFFENS, PAUL G. 8/16/1953 1778 CALICO LANE TOMS RIVER NJ 08753 DEBARMENT 4/23/2003STEGMULLER, JOSEPH MD 3/28/1964 1093793911 15 POINT DRIVE SOMERS POINT NJ 08244 DISQUALIFICATION 1/7/2019STEIG, HERMAN S. DPM 8/27/1951 827 CHARNWOOD DRIVE FRANKLIN LAKES NJ 07417 DISQUALIFICATION 10/19/1999STEIN, MARSHA J. MD 5/3/1956 1831191022 5936 HOWE STREET PITTSBURGH PA 15232 DEBARMENT 3/27/2015STEIN, MICHAEL P. MD 1/29/1949 1174607782 400 RT. 10 WEST RANDOLPH NJ 07869 DISQUALIFICATION 10/5/1999STEIN, MICHAEL P. MD 1/29/1949 1174607782 FMC LEXINGTON LEXINGTON KY 40512 DEBARMENT 8/20/2012STEINBRECHER, DEBRA RN 9/3/1964 2302 WIMBLEDON WAY BLACKWOOD NJ 08012 DISQUALIFICATION 2/26/2010STEINMAN, ARTHUR C. DO 10/15/1946 301 MADISON AVENUE LAKEWOOD NJ 08701 DISQUALIFICATION 11/11/1991STEPASCENKO, SVETLANA CHHA 10/23/1950 100 STONE HILL ROAD, APT. SPRINGFIELD NJ 07081 DEBARMENT 1/22/2016STEPHENS, ALICIA T. PHARM

TECH10/9/1980 5322 RIVERSIDE STATION BL SECAUCUS NJ 07094 SUSPENSION 11/20/2010

STEPHENS, JEFFREY 5/21/1955 411 JAROB COURT POINT PLEASANT NJ 08742 SUSPENSION 3/20/2007STEVENS, FELICIA LPN 5/30/1987 56 WERT AVENUE HAMILTON NJ 08610 DEBARMENT 3/15/2018STEVENS, TRACY M. RN 8/13/1960 501 S. BERLIN AVENUE EGG HARBOR CITY NJ 08215 SUSPENSION 4/20/2003STEWART, SHANTE CHHA 12/12/1971 16B WHITE HORSE PIKE WATERFORD WORKS NJ 08089 DISQUALIFICATION 1/22/2018

STIER, ERIC G. DO 891 OLENTANGY ROAD FRANKLIN LAKES NJ 07417 DEBARMENT 3/6/2000STILL, DAWN AKA ATKINS, CHHA 9/17/1988 697 EVERETT STREET CAMDEN NJ 08104 DISQUALIFICATION 3/6/2018STILLWAGON-AHLERS, COUNSE 11/15/1969 SUNSET LAKE ROAD HARDWICK NJ 07825 SUSPENSION 10/20/2008STILWELL, MELISSA CHHA 419 CATHERINE STREET SOMERVILLE NJ 08876 SUSPENSION 2/19/2004STIMMEL-KEAY, LINDA 5 DRAYTON PLACE WAYNE NJ 07470 DEBARMENT 1/1/2014



103






EXPIRATION DATE

STOCKELBERG, SHOSHANA AKA KAUFMAN, SHOSHANA

LCSW 11/10/1977 349 JESTER COURT OLD BRIDGE NJ 08857 DISQUALIFICATION 7/15/2009 11/7/2014

STOKES, RONALD L. CHHA 11/14/1961 124 6TH AVENUE LONG BRANCH NJ 07740 SUSPENSION 9/19/2003STOKLEY, TWANDA CHHA 7/26/1961 1372 SPRINGFIELD AVENUE IRVINGTON NJ 07111 DISQUALIFICATION 4/18/2017STONE, MARY E. RN 2/19/1954 132 CORBIN COURT LAKEWOOD NJ 08701 SUSPENSION 10/19/2006STOUDEN, ELENA DDS 1/27/1964 1619199882 EAST 83RD STREET NEW YORK NY 10028 SUSPENSION 6/19/2008STOVEKEN, ANDREW 2/4/1950 27-11 RAVENS CREST DRIVE PLAINSBORO NJ 08536 DEBARMENT 5/15/2005STRASHNOV, ALEKSANDR CHHA 7/19/1964 4816 GONIAK DRIVE PARLIN NJ 08859 DISQUALIFICATION 5/18/2017STRASSMAN, ALLAN 5/25/1929 5 ROANOKE AVENUE ROCKAWAY NJ 07866 SUSPENSION 11/16/1998STRASSMAN, ALLAN 5/25/1929 5 ROANOKE AVENUE ROCKAWAY NJ 07886 DISQUALIFICATION 12/1/1998STRASSMAN, CAROL 120 S. 20 TH STREET IRVINGTON NJ 07111 SUSPENSION 3/16/1995STRASSMAN, WAYNE 11/17/1957 2 NEW COUNTRY ROAD SECAUCUS NJ 07094 DISQUALIFICATION 3/5/1998STRINE JR., WALTER M. 173 ROSE VALLEY ROAD MEDIA PA 19063 SUSPENSION 7/11/2001STROBECK, JOHN MD 9/12/1946 1215936299 12 PINE TREE DRIVE SADDLE RIVER NJ 07458 SUSPENSION 6/6/2016STROGOV, EMILIA DPM 5/5/1945 1225115801 COOPER ROAD SCOTCH PLAINS NJ 07076 DISQUALIFICATION 3/24/1995

STRUM, MORTON W. 1360 ARBORDALE ROAD PHILADELPHIA PA 19151 DISQUALIFICATIONSUGGS, SHANTAYA CHHA 10/8/1989 115 HALSTED STREET EAST ORANGE NJ 07018 DEBARMENT 12/26/2017SUH, JEFFREY ACCUPU 10/19/1959 1336523497 FCI FORT DIX, PO BOX 2000 JOINT BASE MDL NJ 08640 DISQUALIFICATION 9/23/2016SULAIMON, TANFEEK CHHA 10/12/1983 321 GARFIELD AVENUE TRENTON NJ 08629 DISQUALIFICATION 1/22/2018SULIMENKO-HOFFMAN, LPN 9/15/1971 99 CREEK ROAD BRICK NJ 08724 DISQUALIFICATION 9/13/2018SULLIVAN, CYNTHIA AKA RPH 6/12/1966 PIN OAK COURT SHAMONG NJ 08088 SUSPENSION 4/20/2008 6/15/2017SULLIVAN, JOHN M. 6/3/1948 PO BOX 2000 LEWISBURG PA 17837 DISQUALIFICATION 7/30/1998SULLIVAN, NOELLE CHHA 10/19/1986 H-9 HUNTER HILLS FLEMINGTON NJ 08822 DISQUALIFICATION 7/14/2017SUN, KENNETH MD 4/19/1961 1881693109 382 EPPS STREET WIND GAP PA 18091 DISQUALIFICATION 3/3/2017SUN, KENNETH MD 4/19/1961 1881693109 15 MOUNTAIN TOP ROAD WIND GAP PA 18091 DISQUALIFICATION 2/20/2018SUNG, KYUNG EUN DDS 9/9/1977 1215122205 428 RUSSELL AVENUE EDGEWATER NJ 07020 DEBARMENT 9/20/2012 2/19/2020SURECK, MORRIS M. OD 4/20/1922 12 NORTH 4TH AVENUE HIGHLAND PARK NJ 08904 DISQUALIFICATION 7/5/1988SUSSMAN, GERALD DO 9/3/1937 6 EAST FIRST AVENUE RUNNEMEDE NJ 08708 SUSPENSION 5/20/1998SUTTON, DEJA CHHA 1/26/1992 802 MAIN STREET 1-3 TOMS RIVER NJ 08753 DISQUALIFICATION 5/2/2017SVERDLOV, GREGORY 11/20/1957 269 SHEFFIELD STREET MOUNTAINSIDE NJ 07092 DISQUALIFICATION 8/7/1998SWAIN, CHERIE CHHA 10/6/1968 2217 NORTH 43RD STREET PENNSAUKEN NJ 08110 DEBARMENT 3/6/2018



104






EXPIRATION DATE

SWARAY, MAYANGBE CHHA 5/12/1985 314 MORRIS AVENUE NEWARK NJ 07103 DISQUALIFICATION 4/14/2014SWEITZER, JANET 8/31/1930 950 ORCHARD AVENUE, LOT

28CAMP HILL PA 17011 DISQUALIFICATION 11/20/2015

SZARSZEWSKI, MARK A. RPH 6 MARIGOLD COURT EDISON NJ 08820 SUSPENSION 9/20/2005SZTYBEL, ELVIRA 35 PEACHTREE ROAD OAKHURST NJ 07755 DISQUALIFICATION 7/18/2001T & N PHARMACEUTICAL 90 WASHINGTON STREET EAST ORANGE NJ 07017 SUSPENSION 9/22/2000TABOTABO, ARMANDO MD 6/18/1940 12 WEST FRONT STREET KEYPORT NJ 07735 DEBARMENT 4/12/2001TADROS, AMIR RPH 8/22/1977 6 ALEXANDER COURT JERSEY CITY NJ 07305 DISQUALIFICATION 6/30/2010 2/5/2018TADROS, AMIR RPH 8/22/1977 6 ALEXANDER COURT, APT. JERSEY CITY NJ 07305 DEBARMENT 12/20/2012 2/5/2018TAFT, ARNOLD 333 NORTH BROAD STREET ELIZABETH NJ 07028 SUSPENSION 7/21/1997

TANDLER, ROBERT OD 8/21/1950 1104812924 792 GREEN LANE UNION NJ 07013 DEBARMENT 4/29/2016 10/27/2017TAORMINA, PHILIP MD 8/27/1976 1689810723 1 APPLETREE LANE SEWELL NJ 08080 DISQUALIFICATION 2/5/2019TAPPER, FREDERIC S. DO 7/8/1951 39 BROOKSIDE DRIVE WARREN NJ 07059 DEBARMENT 8/21/2000TAPPIA, YEALESEH CHHA 7/15/1994 941 IVORIE COURT BURLINGTON NJ 08016 DISQUALIFICATION 2/8/2017TARA, HAROLD H. MD 10/17/1929 48 BROOKWOOD DRIVE WAYNE NJ 07470 DISQUALIFICATION 6/1/1993 DECEASEDTARANTO, SHERRY L. DENTAL 26 COOMES STREET NORWICH NY 13815 DEBARMENT 12/2/2012TARASEVICH, LISA AKA LPN 4/20/1961 206 LAKEHURST AVENUE, NATIONAL PARK NJ 08063 SUSPENSION 9/19/2002TARKAS, SURBHI 8 CARLTON COURT EAST BRUNSWICK NJ 08816 SUSPENSION 6/23/2004TARTE, DEWAYNE LPN 11/3/1971 4014 HAMILTON DRIVE VORHEES NJ 08043 DISQUALIFICATION 8/17/2019TARVER, JOLYCE CHHA 5/16/1989 15 HEATHWOOD AVENUE JACKSON NJ 08527 DISQUALIFICATION 8/22/2017TASCA, ANTHONY J. RN 11 SAWGRASS COURT BLACKWOOD NJ 08012 SUSPENSION 10/20/2003TAUSCHEK, JENNIFER L. CHHA 3/1/1978 154 MAPLE AVENUE TUCKERTON NJ 08087 SUSPENSION 9/20/2005TAVERA, CESAR 2/25/1964 812 LONGWOOD AVENUE CHERRY HILL NJ 08002 SUSPENSION 9/11/2017TAVERA, MARIA 2/25/1964 812 LONGWOOD AVENUE CHERRY HILL NJ 08002 SUSPENSION 9/11/2017 10/3/2019TAVERA, MARIA 2/25/1964 812 LONGWOOD AVENUE CHERRY HILL NJ 08002 DISQUALIFICATION 10/3/2019TAYLOR, BARBARA AKA 12/14/1965 363 KENTWOOD BOULEVARD BRICK NJ 08724 DEBARMENT 10/24/2008TAYLOR, JANICE CHHA 3/14/1953 66 DUFFIELD DRIVE SOUTH ORANGE NJ 07079 DISQUALIFICATION 2/8/2017TAYLOR, KANIKA CHHA 12/22/1988 17 HUNTINGTON TERRACE,

FLOOR 2NEWARK NJ 07112 DISQUALIFICATION 9/10/2019

TAYLOR, STEVEN RN 7/19/1965 25 SYLVAN LANE WILLINGBORO NJ 08046 DISQUALIFICATION 7/20/2017TAYLOR, THOMAS MD 7/19/1943 1356454292 1402 CASTLE COURT HOUSTON TX 77006 DISQUALIFICATION 5/1/2017TAYLOR, TIANN RN 3/22/1967 PO BOX 4004 CLINTON NJ 08809 DEBARMENT 6/20/2006TELANG, FRANK W. MD 12/5/1955 1497798706 1030 N. KINGS HIGHWAY CHERRY HILL NJ 08034 DEBARMENT 8/28/2014



105






EXPIRATION DATE

TELANG, FRANK W. MD 12/5/1955 1497798706 1030 W. KINGS HIGHWAY CHERRY HILL NJ 08034 DISQUALIFICATION 12/5/1997TELGHEDER, MARGARET 7/24/1954 75 SPRING VALLEY ROAD MONTVALE NJ 07645 SUSPENSION 6/20/2002TENSLEY, SHENEQUA 10/11/1973 364 EAST MOORE STREET NORRISTOWN PA 19401 DISQUALIFICATION 11/20/2015TERCHIO, GAETANO FRED 104 E PALISADE BOULEVARD PALISADE PARK NJ 07650 DISQUALIFICATIONTERPENNING, CLARENCE PHD 303 CARTER ROAD PRINCETON NJ 08540 DISQUALIFICATION 11/19/1986TERWILLIGER, KRISTINE RN 7/8/1976 1 DUANE STREET JAMESBURG NJ 08831 DISQUALIFICATION 10/25/2016TESHNER, TERRI PHARM

TECH4/1/1963 300 NORTH BLACK HORSE

PIKE, APT. B-1RUNNEMEDE NJ 08078 DISQUALIFICATION 12/26/2016

THAMES, DOUGLAS A. MD 7/22/1964 218 WEST AVENUE PITMAN NJ 08071 SUSPENSION 3/20/2001THEUNE, CHRISTOPHER DO 12/30/1966 1639141583 5678 BERKSHIRE VALLEY OAK RIDGE NJ 07438 DEBARMENT 10/15/2012 10/15/2015THEUNE, CHRISTOPHER DO 12/30/1966 1639141583 32 WARNER ROAD NEWTON NJ 07860 DISQUALIFICATION 6/5/2017THOMAS, ERIC MD 1/16/1967 1528378072 8460 EVERGREEN DRIVE HELENA MT 59602 DISQUALIFICATION 2/22/2018 PERMANENTTHOMAS, GWENDOLYN LPN 5/22/1941 48 ROANOKE STREET WOODBRIDGE NJ 07095 DISQUALIFICATION 3/3/2017THOMAS, LISA M. CHHA 8/16/1968 402 UNION AVENUE, APT. #3 IRVINGTON NJ 07111 SUSPENSION 4/20/1999THOMAS-MCNAIR, 6/17/1939 590 BELLVUE AVENUE TRENTON NJ 08618 DISQUALIFICATION 12/21/1999THOMPSON, ARTHUR V. 855 THORNHILL COURT LAKEWOOD NJ 08701 SUSPENSION 1/19/2010THOMPSON, DAPHNE CNA 2247 HIGH STREET ORANGE NJ 07050 DEBARMENT 3/29/2002THOMPSON, DEBORAH A. LPN 1/29/1952 1006 COLLINGS AVENUE CAMDEN NJ 08102 SUSPENSION 6/19/2003

THOMPSON, KENNETH H. EMT 12/6/1967 408 SADDLE COURT FLEMINGTON NJ 08822 DISQUALIFICATION 4/28/2003THOMPSON, LORNA MD 6/5/1957 20 OAK POINT DRIVE SO. BAYVILLE NY 11709 SUSPENSION 8/20/2000THOMPSON, SHAKEEMA CHHA 1/26/1982 1034 ANNA STREET ELIZABETH NJ 07201 DISQUALIFICATION 2/26/2018THOOMPALLY, SRINATH RPH 7/30/1967 1235381443 18 LAFAYETTE CIRCLE TOTOWA NJ 07512 DEBARMENT 12/5/2013 12/17/2015

THOTTEMPUDI, VENKATA 11/4/1967 13 VINCENT BEHAN BOULEVARD

EDISON NJ 08837 DISQUALIFICATION 4/12/2012

THOTTEMPUDI, VENKATA 11/4/1967 13 VINCENT BEHAN BOULEVARD

EDISON NJ 08837 DISQUALIFICATION 9/9/2013

THUMMEL, HOPE LPN 11/2/1971 246 WEST BROAD STREET PAULSBORO NJ 08066 DISQUALIFICATION 11/9/2019TICE, LINDSEY LPN 3/19/1982 20 PARVINS MILL ROAD BRIDGETON NJ 08302 SUSPENSION 9/20/2005TIDD, MILES LPN/RN 26 CORAL TREE COURT TRENTON NJ 08648 SUSPENSION 6/20/2005 1/9/2012TIGHE, GERALD 8/15/1957 26 SOUTH ARLENE DRIVE WEST LONG BRANCH NJ 07764 DISQUALIFICATION 12/26/2018TIMMONS, JAWANNA CHHA 10/13/1991 609 FOURTEENTH AVENUE PATERSON NJ 07504 DISQUALIFICATION 7/10/2018



106






EXPIRATION DATE

TISCORNIA, KIMBERLY RN 12/9/1972 18 TORNE MOUNTAIN ROAD WEST MILFORD NJ 07480 SUSPENSION 6/20/2005

TOBACK, BARRY RPH 4/8/1952 1375 RIVER ROAD EDGEWATER NJ 07020 SUSPENSION 6/19/2003TOFANI, NANCY 8/3/1954 114 COUNTY ROAD 513 PITTSTOWN NJ 08867 SUSPENSION 6/14/2000TOMLIN, CANDICE PHARM 9/23/1980 1255517934 38-19 FAIRLAWN AVENUE FAIRLAWN NJ 07410 DISQUALIFICATION 9/9/2016TOMLIN, TERESA L. DPM 8/16/1961 232 KRISTINE AVENUE MANAHAWKIN NJ 08050 SUSPENSION 3/5/2008TOMPKINS, AMBER LPN 7/25/1990 17 LEHIGH ROAD PARLIN NJ 08859 DISQUALIFICATION 6/15/2018TONG, DARLENE M. RPH 9/27/1971 108 LOWER LANDSDOWN ANNANDALE NJ 08801 SUSPENSION 11/12/2009TORIBIO, ANTHONY X-RAY 11 BYRON DRIVE LOPATCONG NJ 08865 SUSPENSION 9/28/2001TORO, NORMARY CHHA 11/16/1989 1173 ATLANTIC AVENUE,

APT. BCAMDEN NJ 08104 DISQUALIFICATION 2/8/2017

TORPPEY, JONI LPN 4/5/1959 28 CHURCH ROAD NEWTON NJ 07860 DISQUALIFICATION 6/5/2017TORRES, FRANCES AKA CHHA 3/28/1973 437 STUYVESANT AVENUE IRVINGTON NJ 07111 DISQUALIFICATION 4/27/2007TORRES, JAIME 9/13/1950 14TH STREET, U-25 BAYAMO PR 00959 SUSPENSION 6/7/2000TORRES, MANUEL G. 5/18/1945 ST. 18 ATE, PRADERA TOA BAJA PR 00940 SUSPENSION 6/7/2000TORRES, MILESTY CHHA 6/4/1982 407 NORTH 31ST STREET CAMDEN NJ 08105 DISQUALIFICATION 1/31/2017TORRESS, KRISTINA CHHA 8/28/1991 53 STEGMAN STREET, APT. JERSEY CITY NJ 07305 DISQUALIFICATION 1/24/2018TOSCANO, SYLVIA 13 NORTHGATE WAY TOMS RIVER NJ 08753 DEBARMENT 8/12/2013 11/14/2018TOTH, TEREZIA M. MD 9 N 2ND AVENUE HIGHLAND PARK NJ 08904 DISQUALIFICATION 3/6/2006TOUCH OF LIFE, LLC. CHELSEA AVENUE NEWARK NJ 07106 SUSPENSION 3/9/2008TOUSSAINT, VALENTINA 240 WEST 104TH STREET NEW YORK NY 10025 DISQUALIFICATION 2/8/2006

TOUTEBON, LEON CHHA 11/8/1965 242 HALSTED STREET, 2ND FL EAST ORANGE NJ 07018 DISQUALIFICATION 7/10/2018

TOY, SUSAN 12/20/1971 727 SUMMIT ROAD UNION NJ 07083 DISQUALIFICATION 2/9/2017TRASTER, LAWRENCE 19 BRAEMAR DRIVE WAYNE NJ 07470 DISQUALIFICATION 9/21/1983TRAVERSO, JOSEPH L. MD 2/21/1946 5 OLD SALEM ROAD WEST ORANGE NJ 07052 SUSPENSION 9/20/2005TRAYNOR, PATRICK 6/22/1941 2314 WOODLAND ROAD ABINGTON PA 19001 DEBARMENT 12/5/2003TREGO-CAMPION, ANITA RPH 8/15/1960 136 S. FELLOWSHIP ROAD MAPLE SHADE NJ 08052 SUSPENSION 10/20/2005TREMO, GREGORY RPH 11/21/1966 13276 WHIPPINGHAM NEW CARROLTON VA 23314 SUSPENSION 11/20/2006TRENTACOSTA, GREG S. DC 10/9/1971 1720293079 1565 RATZER ROAD WAYNE NJ 07470 SUSPENSION 6/20/2005TRINIDAD, TITO B. MD 9/2/1939 PO BOX 1000 #10912-068 LEWISBURG PA 17837 SUSPENSION 11/10/1996TRIVEDI, AMRITLAL PHD 6/30/1928 20 CYPRESS ROAD BURLINGTON NJ 08016 DISQUALIFICATION 5/2/1978TROLLINGER, ROBERT J. MD 4/9/1926 212 ROUTE 541 NORTH MEDFORD NJ 08055 DEBARMENT 10/10/2001



107






EXPIRATION DATE

TSAI, DAVID MD 11/1/1965 12 NORTH 7TH AVENUE MOUNT VERNON NY 10550 DEBARMENT 6/23/2000TSIRKINA, NATALIA 5/21/1955 13675 PHILMONT AVENUE PHILADELPHIA PA 19116 DISQUALIFICATION 11/20/2015TUCHMAN, ALAN P. DPM 10/2/1946 1851380851 WEST MAIN STREET FREEHOLD NJ 07728 SUSPENSION 4/21/2008 8/29/2011TUCKER, APRIL CHHA 3/11/1981 193 BENNER AVENUE NEWARK NJ 07112 DISQUALIFICATION 7/14/2017TUCKER, BURT A DDS 11/20/1937 530 BRICK BOULEVARD BRICKTOWN NJ 08723 DISQUALIFICATION 12/31/1999 DECEASEDTUCKER, KAREN E. DPM 5/24/1965 1992052930 1 BERYNWOOD AVENUE MARLTON NJ 08053 SUSPENSION 7/20/2002 7/15/2016TUCKER, SUZANNE RN 8/1/1964 127 GAYWOOD AVENUE COLONIA NJ 07067 SUSPENSION 5/20/2001TULSANIA, NITAN 7/1/1955 40 BROOKSIDE ROAD EDISON NJ 08817 DEBARMENT 4/27/2004TUMAS, MARY DC 9/13/1953 537 FISK AVENUE BRIELLE NJ 08730 DISQUALIFICATION 7/28/2014TUMIWA, ARNOLD RN 4/20/1984 44 CIRCLE PLACE LAKEWOOD NJ 08701 DISQUALIFICATION 5/2/2018TUNG, MING C. DPM 10/15/1944 1043387608 MITCHELL AVENUE EAST BRUNSWICK NJ 08816 SUSPENSION 8/24/2007TURNER, KIM AKA HALL, 11/18/1965 5 UNAMI LANE SCOTCH PLAINS NJ 07076 DISQUALIFICATION 1/23/2009 PERMANENTTURTON, IAN LPN 7/6/1968 52 BAY SHORE DRIVE TOMS RIVER NJ 08753 DISQUALIFICATION 4/24/2018TWEED, DONNA RN 10/20/1958 60 BAYSHORE ROAD CAPE MAY NJ 08204 DISQUALIFICATION 12/30/2019 PERMANENTTYER, DOUGLAS D. 175 1ST STREET, APT. 16L NEWARK NJ 07102 DISQUALIFICATION 11/22/2005TYRELL, MARK N. RPH 1/11/1955 58 HAVERHILL AVENUE LITTLE FALLS NJ 07424 SUSPENSION 8/19/2004TYSHKOV, MICHAEL MD 6/30/1954 1902882038 87 SHREWSBURY DRIVE LIVINGSTON NJ 07039 DISQUALIFICATION 4/8/2019TYSHOV, MICHAEL MD 6/30/1954 1902882038 87 SHREWSBURY DIRVE LIVINGSTON NJ 07039 DISQUALIFICATION 4/1/2021 PERMANENTUHLIG, CYNTHIA 7/26/1957 204 WYOMING STREET WESTFIELD NJ 07090 SUSPENSION 9/20/2006UHUNMWANGHO, CHHA 11/29/1996 818 SOUTH 18TH STREET NEWARK NJ 07108 DISQUALIFICATION 9/12/2017UKO, BRIDGET CHHA 4/19/1956 47 HEMPSTEAD DRIVE SOMERSET NJ 08873 DISQUALIFICATION 7/14/2017 PERMANENTUMSTEAD, LINDA CHHA 8/13/1970 143 NORTHUMBERLAND

DRIVETOMS RIVER NJ 08757 DISQUALIFICATION 7/9/2018

UNION CITY DIAGNOSTIC 2201 BERGENLINE AVENUE UNION CITY NJ 07007 DEBARMENT 6/10/2001UNITED DENTAL CENTER 35 WALLINGTON AVENUE WALLINGTON NJ 07057 SUSPENSION 9/18/2003

UNITED DIAGNOSTIC LAB, 100 CRAIG ROAD, SUITE 104 MANALAPAN NJ 07726 SUSPENSION 4/18/1997UNITED PHARMACY 1347 SPRINGFIELD AVENUE IRVINGTON NJ 07111 DEBARMENT 7/30/2005

UNIVERSAL MEDICAL LAB. 43 MOONACHIE ROAD HACKENSACK NJ 07601 DISQUALIFICATION 5/10/1999UNIVERSAL MEDICAL 845 BERGEN AVENUE JERSEY CITY NJ 07306 DISQUALIFICATION 6/14/1994URVINA ESTRADA, GINA CHHA 5/18/1961 169 JACKSON STREET PASSAIC NJ 07055 DISQUALIFICATION 7/31/2017



108






EXPIRATION DATE

US CLINICAL LABORATORY, INC.

185 S. EUCLID STREET PASADENA CA 91101 DEBARMENT 4/22/1997

V.C. LABORATORY, INC. 9 COURTLAND AVENUE STATEN ISLAND NY 10301 DISQUALIFICATION 3/24/2003VALDES JR., ALFREDO TNT 10/27/1974 1780644427 135 HAZEL STREET, APT. 65 CLIFTON NJ 07011 DISQUALIFICATION 1/29/2018VALENCIA, RAFAEL MD 4/28/1950 1518045525 146 LAKEVIEW DRIVE GIBBSBORO NJ 08026 DISQUALIFICATION 11/9/2017 PERMANENTVALENZUELA, ROGER CHHA 11/4/1991 517 LINCOLN STREET UNION CITY NJ 07087 DISQUALIFICATION 2/8/2017VALLEJOS, ANA CHHA 10/29/1975 943 NORTH BROAD STREET ELIZABETH NJ 07208 SUSPENSION 5/14/2007VALMON, CAMILLE CHHA 10/18/1990 1106 SUMMER WIND DRIVE JONESBORO GA 30236 DISQUALIFICATION 2/8/2017

VALUE-RITE PHARMACY, INC.

350 WEST MARKET STREET NEWARK NJ 07107 SUSPENSION 4/29/1977

VANDYK, TRICIA 8/24/1975 1412 ISABELLE COURT BRICK NJ 08724 DISQUALIFICATION 8/11/2012 8/10/2014VANSCIVER, SUZANNE RN 10/4/1965 1187 NESHAMINY VALLEY BENSALEM PA 19020 DISQUALIFICATION 6/28/2017VARSOS, ARISTIDES G. MD 2/26/1925 28 47 37TH STREET ASTORIA NY 11103 DISQUALIFICATION 2/24/1986 DECEASEDVASKO, OLGA 7/27/1968 3 PARKWOOD DRIVE SOUTH AMBOY NJ 08879 DISQUALIFICATION 7/10/2003 11/18/2019VASOYA, PRAVIN MD 3/27/1967 1770665135 METROPOLITAN DETENTION BROOKLYN NY 11232 DISQUALIFICATION 8/1/2009VASSERMAN, ALEKSANDR PARAME 10/7/1983 851 RED LION ROAD, APT. E1 PHILADELPHIA PA 19115 DISQUALIFICATION 11/20/2015VASSERMAN, IRINA 11/30/1962 851 RED LION ROAD, APT. E1 PHILADELPHIA PA 19115 DISQUALIFICATION 11/20/2015VASTEY, GARDY DC 3/25/1970 1114148806 1144 USTLER ROAD APOPKA FL 32712 DISQUALIFICATION 6/28/2017VASWANI, VIJAY MD 11/29/1968 1194785956 9 TYNMOUTH DRIVE LUMBERTON NJ 08048 DEBARMENT 2/15/2016VECCHIONE, JOHN DDS 6/5/1968 1710926076 2 LORRAINE DRIVE PARK RIDGE NJ 07656 DEBARMENT 8/31/2016VECCHIONE, JOHN DDS 6/5/1968 1710926076 1 CAROL DRIVE ENGLEWOOD CLIFFS NJ 07632 DISQUALIFICATION 2/20/2017VEGA, DEBORAH 9/30/1958 2409 BOOKER AVENUE UPPER CHICHESTER PA 19014 DISQUALIFICATION 11/20/2015VELOSO, CESAR MD 2/16/1939 1104800333 532 AMSTERDAM AVENUE RIDGEWOOD NJ 07450 DISQUALIFICATION 6/20/2018VENANZI, ENZO DO 9/29/1927 107 NORTH BROAD STREET WOODBURY NJ 08096 DISQUALIFICATION 9/9/1996VENDETTI CLINICAL LABORATORY, INC.

904D OAK TREE ROAD SOUTH PLAINFIELD NJ 07080 DEBARMENT 12/1/1999

VENKATRAM, MD 5/6/1955 3305 VILLAGE DRIVE AVENEL NJ 07001 DEBARMENT 11/28/1998VENTURA, MARIA CHHA 8/2/1946 135 BELMONT STREET, #204 JERSEY CITY NJ 07304 DISQUALIFICATION 8/22/2017VERBARO, DENNIS DC 1/9/1951 1558426122 384 MAIN STREET CHESTER NJ 07930 DISQUALIFICATION 12/1/1998VERDELL, CLARENCE MD 7/13/1950 1649206376 107 WHITEHALL DRIVE VOORHEES NJ 08043 DISQUALIFICATION 8/20/2018VICENTI, CARMILLA C. MD 40-15 QUAIL RIDGE ROAD PLAINSBORO NJ 08536 SUSPENSION 3/18/1999VICIOSO, MARGARITA MD 4/9/1959 1922058932 7801 BUSTLETOWN AVENUE, PHILADELPHIA PA 19152 DISQUALIFICATION 12/29/2015



109






EXPIRATION DATE

VICTORY PHARMACY 1238 SPRINGFIELD AVENUE IRVINGTON NJ 07111 SUSPENSION 2/2/2008VIGGIANO, DIANE RN 5/24/1989 188 COACHMAN DRIVE N FREEHOLD NJ 07728 DISQUALIFICATION 7/22/2017VILLAMOR, MANUEL THERAPI 11/8/1953 9030 SW 29TH TERRACE MIAMI FL 33155 SUSPENSION 3/20/2005VILLONE, MARY 10/13/1956 DUNMORE STREET JIM THORPE PA 18512 DISQUALIFICATION 5/4/2005VILSHTEYN, ROSTISLAV 9/7/1978 50 PAMELA LANE STATEN ISLAND NY 10304 DISQUALIFICATION 10/31/2012VINCI, JUDITH RN 12/21/1948 202 BRUNSWICK AVENUE SPOTSWOOD NJ 08884 SUSPENSION 6/19/2003VINING, DONNA DO 12/27/1950 33 1/2 PEMBROOKE ROAD DANBURY CT 06811 DEBARMENT 7/5/2001VINUELA, ANDRES MD 3/17/1973 1649539479 1910 NE 27TH COURT, APT. 1 LIGHTHOUSE POINT FL 33064 DEBARMENT 7/15/2019VIRZI, JOSEPH PO BOX 164 JAMESBURG NJ 08831 SUSPENSION 1/9/1996VISCOMI, DOMINIC A. DDS 10/29/1941 926 DUCK POND ROAD NEWTON NJ 07860 DEBARMENT 5/31/2001VISCONTI, PAUL A. DO 10/13/1964 120 OLD COMMACK ROAD KINGS PARK NY 11754 DEBARMENT 6/27/2001 10/25/2013VITALE, JACK RPH 9/5/1940 17 CORNELL PLACE MANALAPAN NJ 07726 SUSPENSION 6/22/1999VITALE, JACK RPH 9/5/1940 17 CORNELL PLACE MANALAPAN NJ 07726 SUSPENSION 5/2/2000

VITALI, JOHN MD 12/5/1961 1609829985 1 SHIRA LANE MANALAPAN NJ 07726 DEBARMENT 1/22/2016

VITALI, JOHN MD 12/5/1961 1609829985 1 SHIRA LANE MANALAPAN NJ 07726 DISQUALIFICATION 6/3/2016

VOGEL III, FRANK MD 1/6/1945 271 BELMONT PLACE MAHWAH NJ 07430 DEBARMENT 8/28/2014VOGEL, BARRY M. MD 5/26/1942 200 HIGHLAND AVENUE GLEN RIDGE NJ 07028 DEBARMENT 9/8/2000VOROBYEV, LEONID MD 4/10/1961 1245259431 PERRY STREET MORGANVILLE NJ 07751 SUSPENSION 8/20/2008 6/17/2014VOUDOURIS, APOSTOLOS MD 8/16/1973 1801160767/1 3 HUNTERS CROSSING ROAD SOMERSET NJ 08873 DISQUALIFICATION 8/16/2017 12/2/2018VOUDOURIS, APOSTOLOS MD 8/16/1973 1801160767/1 3 HUNTERS CROSSING ROAD SOMERSET NJ 08873 DEBARMENT 12/3/2018VOUDOURIS, APOSTOLOS MD 8/16/1973 1801160767/1 FMC DEVENS, PO BOX 879 AYER MA 01432 DISQUALIFICATION 5/18/2019VOYTENKO, DC 10/10/1971 1174556229 2780 WEST 5TH STREET, APT. BROOKLYN NY 11224 DISQUALIFICATION 2/11/2016VOZNYUK, PETRO CHHA 1/7/1954 5 PULAWSKI AVENUE SOUTH RIVER NJ 08882 DISQUALIFICATION 2/20/2017VOZNYUK, PETRO CHHA 1/7/1954 5 PULAWSKI AVENUE SOUTH RIVER NJ 08882 DEBARMENT 4/18/2017WACTOR, DONNA RN 6/26/1955 71 FOREST STREET MONTCLAIR NJ 07042 SUSPENSION 6/19/2003WAGERS, DAVID OD 8/12/1970 1710928239 540 OLD FARM ROAD PALMYRA PA 17078 DISQUALIFICATION 11/20/2015WALDRON, JOHN F. MD 6/20/1914 920 CEDARBRIDGE ROAD BRICKTOWN NJ 08723 DISQUALIFICATION 6/21/1979



110






EXPIRATION DATE

WALKER, ASHLEY RN/PA 5/1/1989 841 HILLTOP ROAD ERIE PA 16509 DISQUALIFICATION 11/20/2015WALKER, BARBARA D. CHHA 1/22/1966 120 N. ORATON PARKWAY, EAST ORANGE NJ 07017 DISQUALIFICATION 7/20/2002WALKER, RUSSELL 12/20/1983 910 MORNING GLORY ROAD JACKSON NJ 08527 DISQUALIFICATION 1/10/2010

WALL PHARMACY 2510 BELMAR BOULEVARD WALL NJ 07719 SUSPENSION 2/5/2003WALLER, ALFONSO H. MD 3/14/1931 131 37TH STREET UNION CITY NJ 07087 DISQUALIFICATION 9/14/1983WALLIS, JODIE RN 11/17/1964 601 FAIRVIEW LANE WILLINGBORO NJ 08046 SUSPENSION 10/18/2001WARD, KEVIN DDS 8/13/1957 1487842647 27 FIRETOWER ROAD BUDD LAKE NJ 07828 DISQUALIFICATION 11/1/2019 PERMANENTWARD, KEVIN DDS 8/13/1957 1487842647 27 FIRETOWER ROAD BUDD LAKE NJ 07828 DEBARMENT 9/15/2017WASHINGTON JR., ANKOMO

CHHA 7/30/1993 174 EAST 6TH STREET CLIFTON NJ 07011 DISQUALIFICATION 2/8/2017

WASHINGTON, JOHN 9/13/1951 2 TUERS PLACE MONTCLAIR NJ 07043 SUSPENSION 4/29/1997WASHINGTON, WAH'TAYVIA

CHHA 11/28/1991 144 BIDWELL AVENUE JERSEY CITY NJ 07305 DISQUALIFICATION 2/8/2017

WASHINGTON-BHAMRE, APN/RN 9/15/1965 166 MAPLE STREET, APT. 23 ROSELLE PARK NJ 07204 DISQUALIFICATION 3/2/2020WASSEF, ADEL A. MD 2/10/1932 123 SOUTH MUNN AVENUE EAST ORANGE NJ 07019 SUSPENSION 2/18/1998WATSON, LORENZO PHARM 8/7/1984 500 ADAMS LANE NORTH BRUNSWICK NJ 08902 DISQUALIFICATION 11/21/2016WATSON, MARC C. MD 2/29/1948 1578605929 912 POMPTON AVENUE,

#9B1CEDAR GROVE NJ 07009 SUSPENSION 4/1/2001

WATSON, TRACEY L. LPN 12/23/1970 1 GRUMMAN AVENUE, APT. NEWARK NJ 07112 DISQUALIFICATION 1/23/2006WATZMAN, MARC MD 7/6/1966 PO BOX 1000 LORETTO PA 15940 DEBARMENT 8/30/2007WEAH, JEROME 2/23/1976 PO BOX 190 AVENEL NJ 07001 DISQUALIFICATION 1/14/2011WEBB, ALNESHA CHHA 1/7/1993 328 IRVINE TURNER ROAD NEWARK NJ 07108 DISQUALIFICATION 1/29/2018WEBB, CURTIS O. RN 12/23/1952 110 CROSSHILL DRIVE BANGOR PA 18013 SUSPENSION 12/19/2002WEBB, LATISA CHHA 2/1/1973 1060 BROAD STREET, APT. NEWARK NJ 07102 DISQUALIFICATION 5/9/2019WEBER, MARC DDS 6/2/1966 1609064062 326 BROAD STREET RED BANK NJ 07701 SUSPENSION 11/5/2009 9/30/2010WEBER, MARGARET LPN 10/23/1958 2920 STATE ROUTE 23 NEWFOUNDLAND NJ 07435 SUSPENSION 12/18/2003WEIDER, ABE 3301 FOSTER AVENUE BROOKLYN NY 11203 SUSPENSION 12/21/2001WEIGAND, DAVID RN 1/13/1969 310 VILLAGE DRIVE SOMERSET NJ 08873 SUSPENSION 3/20/2001WEIN, FRED R. RPH 10/5/1953 111 TANGERINE DRIVE MARLBORO NJ 07746 SUSPENSION 5/19/2005WEINSTEIN, LEONARD MD 10/15/1931 1 TRENT ROAD MONROE TOWSHIP NJ 08831 SUSPENSION 8/20/2003 WEINSTEIN, MARTIN H. DPM 12/30/1955 601 2ND AVENUE LONG BRANCH NJ 07740 DISQUALIFICATION 6/19/2008WEINTRAUB, FREDERICK DPM 10/12/1951 1225131550 17 HARVEY LANE UPPER SADDLE RIVER NJ 07458 DISQUALIFICATION 2/15/2016WEISELBERG, ALAN 12/7/1945 8900 S.W. 61ST STREET MIAMI FL 33156 DISQUALIFICATION 6/5/2000



111






EXPIRATION DATE

WEISS, CHERIE PA 4/21/1976 1861435828 801 ABBEY ROAD MIDDLETOWN NJ 07748 DEBARMENT 12/16/2015WEISS, MURRAY 12/25/1925 80 SKY MEADOW WHITE PLAINS NY 10607 DISQUALIFICATIONWELCH, SHIRLEY 5/8/1947 SCENIC DRIVE FREEHOLD NJ 07728 SUSPENSION 8/20/2007WELLES, ANTONNETTE CHHA 10/21/1994 124 S. OLDEN AVENUE TRENTON NJ 08609 DISQUALIFICATION 2/8/2017WELLS, CHRISTOPHER W. RPH 1/19/1966 WARRENS WAY WANAQUE NJ 07645 DEBARMENT 10/1/2007WELLS, TAMARA RN 2/9/1960 13 HENRY STREET BERGENFIELD NJ 07621 DISQUALIFICATION 6/8/2018WELLS, WARREN CHHA 11/1/1971 202 BEAR BROOK ACRES

DRIVEMADISON TOWNSHIP PA 15663 DISQUALIFICATION 11/20/2015

WERBIN, MARIS AKA RPH 8/11/1957 126 RIVER DRIVE LAKE HIAWATHA NJ 07034 SUSPENSION 8/20/2006WERTHEIM, HOWARD RPH 8/18/1948 19 KNOB HILL ROAD HACKETTSTOWN NJ 07840 SUSPENSION 12/20/2004WERTHEIM, HOWARD RPH 8/18/1948 696A FRIAR COURT MANCHESTER NJ 08759 DISQUALIFICATION 12/12/2016WERTHEIM, MARC DDS 10/9/1964 1306910427 24 MERCHANTS WAY COLTS NECK NJ 07722 DEBARMENT 8/25/2009WERTHEIM, MARC DDS 10/9/1964 1306910427 80 E. JOSEPH STREET MOONACHIE NJ 07074 DISQUALIFICATION 1/20/2013WESHNAK, NADIA LPN/RN 1/23/1962 382 WOODLAKE MANOR LAKEWOOD NJ 08701 SUSPENSION 10/20/2002WESLEY, JOSEPH W. MD 10/9/1948 246 N FRANKLIN TURNPIKE RAMSEY NJ 07446 DISQUALIFICATION 6/19/2002WESLEY, LACHAE'YA CHHA 7/9/1989 732 OCEAN AVENUE, APT. 11 LONG BRANCH NJ 07740 DISQUALIFICATION 4/18/2017WESLEY, NUEDAH 7/27/1973 10 ROANOKE COURT WILLINGBORO NJ 08046 DEBARMENT 5/28/2013WEST ORANGE 1548326812 11 DOGWOOD LANE EAST HANOVER NJ 07936 DISQUALIFICATION 3/29/2017 PERMANENTWESTFIELD AVENUE PHARMACY

156 COUNTRY FARM ROAD MARLTON NJ 08053 DISQUALIFICATION 9/26/2013

WESTON, MARC OD 4/18/1937 16 BARNETT ROAD LAWRENCEVILLE NJ 08648 DISQUALIFICATION 6/1/1993WHETSTONE, RHONDA CHHA 8/9/1983 73 PEABODY PLACE NEWARK NJ 07104 DISQUALIFICATION 7/27/2017WHITE, CAMEO CHHA 1/19/1969 493 SUMMER STREET #1 PATERSON NJ 07501 DISQUALIFICATION 7/9/2018WHITE, MEGHAN AKA MCLEOD, MEGHAN

CHHA 11/23/1992 271 SERPENTINE DRIVE BAYVILLE NJ 08721 DISQUALIFICATION 5/8/2019

WHITE, PHAEDRA J. RN 3/5/1966 1107 N SALINA STREET #2 SYRACUSE NY 13202 DEBARMENT 11/20/2008WHITE, WAYNE RPH 4/14/1960 1366717514 11001 NORTHWEST 17TH

AVENUEMIAMI FL 33167 DISQUALIFICATION 11/20/2015

WHITE, WENDELL CHHA 4/15/1969 106B CHAUCER ROAD MOUNT LAUREL NJ 08054 DEBARMENT 10/25/2003WHITEHEAD, TARSHEEKA CHHA 1/4/1983 1751 OLIVER STREET RAHWAY NJ 07065 DISQUALIFICATION 2/8/2017WHITEMAN, GERALD J. DDS 2/5/1939 1821191982 RIVERGATE WAY LONG BRANCH NJ 07740 DISQUALIFICATION 1/5/2007 8/22/2019WHITMORE, SHARON T. 1/8/1967 51 DOVER STREET, 2ND NEWARK NJ 07106 DEBARMENT 9/19/2002WHITMORE, SHARON T. 1/8/1967 51 DOVER STREET, 2ND NEWARK NJ 07106 DISQUALIFICATION 8/15/2005



112






EXPIRATION DATE

WHITNEY, MARIS AKA RPH 8/11/1957 126 RIVER DRIVE LAKE HIAWATHA NJ 07034 SUSPENSION 8/20/2006WHITTAKER, MICHELLE CHHA 6/4/1992 801 1/2 4TH AVENUE NEPTUNE NJ 07753 DEBARMENT 8/29/2017WIBLE, BETH RN 11/22/1972 47 NARCUSSUS LANE LEVITTOWN PA 19054 DISQUALIFICATION 6/22/2019WIJETILAKA, ROHAN MD 12/8/1948 1821058694 FCI FORT DIX - PO BOX 2000 FORT DIX NJ 08640 DISQUALIFICATION 5/20/2015WIKLINSKI, STEPHEN L. DC 10/1/1964 1659454981 DEWOLF ROAD OLD TAPPAN NJ 07675 SUSPENSION 10/18/2001WILKING, JULIE RN 8/7/1979 415B WHITMAN DRIVE HADDONFIELD NJ 08033 DISQUALIFICATION 5/2/2017WILKINSON, CHERICE RN 12/12/1973 809 PASSAIC AVENUE SEWELL NJ 08080 DISQUALIFICATION 8/3/2019WILKINSON, PHYLLIS LPN 7/5/1963 8 WINDING RIDGE COURT NEPTUNE NJ 07753 SUSPENSION 9/20/2006WILLARD, VANCE CHHA 4/17/1956 283 FORD AVENUE WESTWOOD NJ 07675 DEBARMENT 1/25/2018WILLER, MAURICE MD 3/19/1928 631 NYE AVENUE IRVINGTON NJ 07111 DEBARMENT 11/6/2000WILLIAMS JR., OTIS A. MD 11/9/1962 106 W. PALISADE AVENUE, ENGLEWOOD NJ 07631 SUSPENSION 7/27/1998WILLIAMS JR., OTIS A. MD 11/9/1962 293 CLASSON AVENUE, APT. BROOKLYN NY 11205 SUSPENSION 2/2/1999WILLIAMS, AMY 5/14/1967 1126 COLLINS ROAD CAMDEN NJ 08104 DEBARMENT 7/15/2004WILLIAMS, ARNISSA 2/18/1974 256 1/2 SOUTH 19TH STREET NEWARK NJ 07103 DISQUALIFICATION 3/25/2006WILLIAMS, BEATRICE CHHA 1/28/1947 37 VIVIAN COURT HOWELL NJ 07731 DISQUALIFICATION 4/22/2002WILLIAMS, CONRAD D. MD 1/28/1949 1841410701 255 EASTERN PARKWAY,

APT. A16BROOKLYN NY 11238 DISQUALIFICATION 8/20/2015

WILLIAMS, CRAIG DMD 3/30/1957 175 CROSS KEYS ROAD BERLIN NJ 08009 SUSPENSION 1/18/2007WILLIAMS, DENEESHAH CHHA 11/6/1991 133 WILLIAM STREET ROSELLE NJ 07203 DISQUALIFICATION 2/8/2017WILLIAMS, DESHAWNA CHHA 11/26/1989 112 CORAL STREET PATERSON NJ 07522 DISQUALIFICATION 9/26/2017WILLIAMS, DIONE MD 12/15/1958 1356437693 1787 SPRINGFIELD AVENUE MAPLEWOOD NJ 07040 DEBARMENT 12/16/2015WILLIAMS, HELIEN 1/25/1986 29 STRATFORD PLACE, APT. NEWARK NJ 07104 DISQUALIFICATION 8/26/2013WILLIAMS, JAMES LLOYD THERAPI 5/26/1966 208 NORTH CHESTNUT SCOTTDALE PA 15683 DISQUALIFICATION 11/20/2015WILLIAMS, JEWEL CHHA 6/3/1990 944 MORTON STREET CAMDEN NJ 08105 DEBARMENT 9/23/2014WILLIAMS, JOHKEMIA CHHA 11/26/1981 7 MELLON STREET TRENTON NJ 08618 DISQUALIFICATION 2/8/2017WILLIAMS, MARCUS MD 6/19/1958 1619057734 1500 LOCUST STREET, APT. PHILADELPHIA PA 19102 DISQUALIFICATION 11/20/2015WILLIAMS, MECCA CHHA 12/7/1992 126 PARKER STREET NEWARK NJ 07104 DISQUALIFICATION 2/8/2017WILLIAMS, VINETTIA 3/6/1966 418 SASSAFRAS STREET MILLVILLE NJ 08360 SUSPENSION 8/20/2006WILLIAMS-KLENA, JOAN 7/7/1933 103 KOMORN STREET NEWARK NJ 07105 DISQUALIFICATION 6/17/1987WILLIAMSON, HELEN 11/4/1981 41 ATLANTIC AVENUE MANAHAWKIN NJ 08050 SUSPENSION 2/20/2008WILLS, LAURA LPN 5/12/1989 14 E. WIND TRAIL, #22 FAIRFIELD PA 17320 DISQUALIFICATION 11/20/2015WILSHIRE, GILBERT MD 5/11/1961 1386679298 1120 ROUTE 22 E BRIDGEWATER NJ 08807 DEBARMENT 12/3/1999WILSON III, FRANKIE M. 3/10/1941 395 NORTH GROVE STREET EAST ORANGE NJ 07017 DEBARMENT 11/24/2007



113






EXPIRATION DATE

WILSON, ELLEN RN/APN 2/3/1975 1144406620 42 THEO COURT BURLINGTON NJ 08016 DISQUALIFICATION 11/20/2015 10/27/2017WILSON, EVELYN LCSW 4/30/1941 209 W. HUDSON AVENUE ENGLEWOOD NJ 07631 DISQUALIFICATION 8/15/2007WILSON, IAN 6/6/1955 724 GROVE STREET IRVINGTON NJ 07111 DISQUALIFICATION 12/24/1985WILSON, TAKEELA CHHA 8/31/1979 135 BERGEN AVENUE, APT. 2- JERSEY CITY NJ 07305 DISQUALIFICATION 4/7/2017WILSON, TASHA M. CHHA 8/25/1971 124 YORK STREET, APT. 64 SALEM NJ 08079 DISQUALIFICATION 1/6/2006WINDMILLER, EDWARD DDS 5/30/1961 1871914036 3731 WALNUT STREET, APT. HARRISBURG PA 17109 DISQUALIFICATION 12/29/2015WINEGARDEN, ROBERT F. DMD 1/21/1949 1306056981 1 ROUTE 27, PARSONAGE EDISON NJ 08820 SUSPENSION 9/20/1999WINEGRAD, ALBERT MD 9/26/1926 1972752855 3220 LENAPE DRIVE DRESHER PA 19025 DISQUALIFICATION 11/20/2015WINGROVE DRUGS, INC. 634 DR. MARTIN L. KING NEWARK NJ 07102 SUSPENSION 6/5/1997WINKY, INC. 2510 BELMAR BOULEVARD WALL NJ 07719 DISQUALIFICATION 1/11/2005

WINTER, JESSICA CHHA 7/9/1986 426 CATHERINE STREET BERGENFIELD NJ 07621 DISQUALIFICATION 2/20/2017WINTHER-GALIMORE, DC 2/1/1975 1134140601 1152 W. US HIGHWAY 54 CAMDENTON MO 65020 DISQUALIFICATION 9/20/2011WISCH, GLENN R. DMD 12/1/1955 6-05 SADDLE RIVER ROAD FAIRLAWN NJ 07410 DISQUALIFICATION 4/29/1996WITEK JR., JOSEPH T. MD 4/28/1969 1063606838 3625 AVENIDA MADEIRA BRADENTON FL 34210 DEBARMENT 10/17/2000WITHINGTON, PAMELA RN 9/9/1960 5 CHERRYVILLE ROAD FLEMINGTON NJ 08822 SUSPENSION 6/20/2005WITMAN, LEEANN 12/30/1964 SCI CAMBRIDGE SPRINGS, CAMBRIDGE SPRINGS PA 16403 DISQUALIFICATION 11/20/2015WOLF, JEFFREY A. DPM 9/14/1948 1100 CLIFTON AVENUE CLIFTON NJ 07103 DISQUALIFICATION 10/14/1997WOLFE, JOSEPH ROUTE 24 MENDHAM NJ 07945 DISQUALIFICATION 6/1/1993WOLFE, MARY LPN 10/5/1953 2760 PINE GROVE ROAD YORK PA 17403 DISQUALIFICATION 11/20/2015WOLFE, WILLIAM MD 10/5/1963 1003872912 27 ROCKINGHAM DRIVE MARLTON NJ 08053 DISQUALIFICATION 9/12/2016 10/18/2019WOLFF, MICHAEL W. LPN 4/15/1986 178 WHITES HILL ROAD ROCHESTER PA 15074 DISQUALIFICATION 12/29/2015WOLFSON, STANLEY MD 11/3/1929 5 CLUBWAY LANE HARTSDALE NY 10530 SUSPENSION 4/19/2001WOLLMAN, ROBERT DDS 5/11/1951 1659429421 461 CENTRAL AVENUE JERSEY CITY NJ 07307 DISQUALIFICATION 11/6/1987WOOD, FAYE W. CHHA 6/30/1958 33 WHITE OAK DRIVE PRINCETON NJ 08540 DISQUALIFICATION 9/25/2002WOODS, CALEDA CHHA 7/25/1977 158 GIRARD AVENUE TRENTON NJ 08638 DISQUALIFICATION 2/8/2017WOODSON, BASSEY 10/4/1962 32 DAYTON STREET, APT. B1 NEWARK NJ 07114 DISQUALIFICATION 9/13/2013WOROSILO, SHARON MD 12/18/1960 1000 AVENUE AT PORT WEEHAWKIN NJ 07086 DISQUALIFICATION 11/8/2017WOUND HEALING ASSOCIATES

3111 ROUTE 38 MOUNT LAUREL NJ 08054 SUSPENSION 11/19/2005

WOZUNK, GEORGE 9/23/1963 1029 E. PARK AVENUE VINELAND NJ 08360 SUSPENSION 3/10/2000WREH-TOE, PALLEH 9/1/1964 3401 MERLOT COURT YORK PA 17404 DISQUALIFICATION 12/29/2015WREIOLE, AUGUST DO 8/21/1949 1942247333 422 MORRIS AVENUE LONG BRANCH NJ 07740 DEBARMENT 7/8/2017 6/12/2019WRIGHT, KIMBERLY A. RN 8/15/1965 27 GLENSIDE AVENUE SUMMIT NJ 07901 SUSPENSION 10/20/2002



114






EXPIRATION DATE

WRIGHT, LYNN I. 2/23/1970 84 PENN STREET BRIDGETON NJ 08090 SUSPENSION 8/17/2008WRIGHT, SALLY A. PSYCH 10/27/1953 1497769160 ALDERSON FPC, GLEN RAY

ROAD BOX AALDERSON WV 24910 DEBARMENT 9/19/2011

WRIGHT, SANDRA CHHA 6/22/1957 4938 NORTH 8TH STREET PHILADELPHIA PA 19120 DISQUALIFICATION 11/20/2015WRIGHT, SHELLY L. RN 9/10/1959 MURTLAND STREET SPRINGDALE PA 15144 DISQUALIFICATION 9/23/2007WRIGHT, SHONEYEH 9/22/1982 CLINTON AVENUE IRVINGTON NJ 07111 DEBARMENT 10/5/2007WRIGHT, SYDNEY CHHA 8/22/1991 111 SHERWOOD AVENUE MAHWAH NJ 07430 DISQUALIFICATION 4/18/2017WUJACK, ALLISON LPN 10/25/1983 308A SUNRISE BOULEVARD FORKED RIVER NJ 08731 DISQUALIFICATION 5/2/2017WYLES, KIMBERLY CHHA 12/31/1989 116 BLACKWOOD-

CLEMONTON ROADCLEMONTON NJ 08021 DEBARMENT 3/5/2018

WYLIE, JOHN D. RPH 11/28/1950 7306 WOODVIEW WAY MALVERN PA 19355 SUSPENSION 7/20/2004YAEGER, CHARLES 8/30/1978 21 BARKALOW AVENUE FREEHOLD NJ 07728 DISQUALIFICATION 6/5/2008YAEGER, HOPE W. RN 9/30/1969 1316 S. 10TH STREET, APT. 2 ALLENTOWN PA 18103 SUSPENSION 8/20/2001 1/5/2018

YAHAV, ERIC MD 6/23/1975 1013156686 1720 DEVONSHIRE ROAD DRESHER PA 19025 DEBARMENT 1/1/2020 5/6/2021YAKHNIS, ANNA RN 8/31/1975 28 SAINT MICHAELS COURT CHURCHVILLE PA 18966 DISQUALIFICATION 11/20/2015YALE, DONNA APPEL LPN 5/2/1954 49 ANGLE INN TRAILER FARMINGDALE NJ 07727 SUSPENSION 9/20/2000YANGBE, PATIENCE CHHA 2/19/1990 730 FRANKLIN STREET TRENTON NJ 08610 DISQUALIFICATION 2/8/2017YATES, QIANNA CHHA 5/5/1979 209 EUTAW STREET CAMDEN NJ 08105 DISQUALIFICATION 4/19/2018YAW, GAYFORD A. PHARM 5/11/1963 504 STEVENS ROAD LANDING NJ 07050 SUSPENSION 5/20/2008YAW, GAYFORD A. PHARM 5/11/1963 504 STEVENS ROAD LANDING NJ 07850 DISQUALIFICATION 9/24/2008YELCICK, JOHN MD 5/15/1965 635 WILLOW GREEN LITITZ PA 17543 DEBARMENT 7/28/2014YEN, YA-TANG MD 5/8/1944 1952374530 2 FAWN PATH HOLMDEL NJ 07733 DISQUALIFICATION 8/21/2019 PERMANENTYEPES, LINA CHHA 1/19/1980 2105 NEW YORK AVENUE, UNION CITY NJ 07087 DISQUALIFICATION 2/20/2017YEPES-SANCHEZ, ONAIDA CHHA 10/9/1961 1815 PALLISADE AVENUE UNION CITY NJ 07086 DISQUALIFICATION 2/8/2017YOON, TOL UNG MD 2/15/1941 9 MALAGA DRIVE BRIDGETON NJ 08302 DISQUALIFICATION 12/1/1998YOUNG, JULIA CHHA 9/9/1975 2019 SOUTH 9TH STREET CAMDEN NJ 08104 DISQUALIFICATION 2/20/2017YOUNGER, ANTHONY 11/24/1969 65 MAIDEN LANE LITTLE FERRY NJ 07643 DEBARMENT 10/15/2008YULE, ROBERT C. RN 6/23/1948 323 FLORENCE ROAD MIDDLETOWN NJ 07748 SUSPENSION 9/19/2003YUNATANOV, STEVE DDS 4/7/1965 1366749962 83-83 118 TH STREET KEW GARDENS NY 11415 SUSPENSION 7/20/2004ZAINELABDIN, AMID 12/12/1950 126 CORBIN AVENUE JERSEY CITY NJ 07306 DISQUALIFICATION 5/21/2002ZAK, FELIX 4/13/1952 825 E. 9TH STREET BROOKLYN NY 11230 DISQUALIFICATION 1/9/2001ZAMAN, TANVIR PHARM 9/25/1980 205 DAVIS AVENUE ABSECON NJ 08201 DISQUALIFICATION 7/18/2018



115






EXPIRATION DATE

ZAMLOOT, PHILIP 10/28/1969 150 PARK ROW NEW YORK NY 10007 SUSPENSION 7/20/2005ZARRELLI, MICHAEL 12/13/1966 FCI FORT DIX - PO BOX 2000 JOINT BASE MDL NJ 08640 DISQUALIFICATION 9/29/2017ZASLOW, LAWRENCE RPH 12/7/1953 323 SOCIETY HILL

BOULEVARD, APT 1CHERRY HILL NJ 08003 DISQUALIFICATION 10/25/2016

ZAWAHIR, MEEYAPILLAI 2/22/1939 91 KNICKERBOCKER ROAD TENAFLY NJ 07670 SUSPENSION 9/20/2006ZELTSER, LAZAR 4/11/1973 2333 MORRIS AVENUE, UNIT UNION NJ 07083 SUSPENSION 6/22/1998ZELTSER, RAISA 9/11/1970 6 PLEASANT VALLEY WAY WEST ORANGE NJ 07079 SUSPENSION 9/14/2000ZERKTI, HOUDA CHHA 7/26/1982 72 KENNEDY BOULEVARD BAYONNE NJ 07002 DISQUALIFICATION 2/8/2017ZIBDIE, YOUSEF MD 5/5/1964 1598714784 163 WEBSTER DRIVE WAYNE NJ 07470 DEBARMENT 12/11/2017ZIBDIE, YOUSEF MD 5/5/1964 1598714784 871 MCBRIDE AVENUE, SUITE WOODLANE PARK NJ 07424 DISQUALIFICATION 8/20/2018ZIHALA, TERESA RN 7/25/1961 148 MAIN STREET SPOTSWOOD NJ 08884 SUSPENSION 9/19/2003

ZIMMERMAN, DANIEL MD 10/13/1947 1801919741 51 ROCKLEDGE ROAD HAWTHORNE NJ 07506 DEBARMENT 12/7/1999 9/5/2012ZIMMERMAN, DANIEL MD 10/13/1947 1801919741 501 BARCLAY WALK CHERRY HILL NJ 08034 DISQUALIFICATION 11/23/2016ZIMNA, GRAZYNA CHHA 3/14/1963 19 NEW JERSEY AVENUE CARTERET NJ 07008 DISQUALIFICATION 2/20/2017ZUBAIR, SAIRA 3/1/1971 18 RAVENSWOOD LANE SCOTCH PLAINS NJ 07076 DEBARMENT 8/1/2017

State of New Jersey Medicaid Fraud Division Provider ...

Documents

Transcript of State of New Jersey Medicaid Fraud Division Provider ...