Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1669445557 Deactivated / Inactive NPI Male Practitioner

Dr. Deane A Penn , MD

Specialist • Fort Lee, NJ

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Deane Penn has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date February 10, 2006
NPI Deactivation Date June 10, 2021
Total Practice Duration ~15 Years of Practice (2006 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Deane Penn, MD was a registered Specialist practicing in Fort Lee, NJ. Throughout an active medical career spanning 15 years, Dr. Penn provided care at the practice location at 1600 PARKER AVE until profile deactivation on 2021-06-10.

Practice Location & Contact Primary Location

Practice Address

1600 Parker Ave

Fort Lee, NJ 070247050

Telephone 2014612507
Fax 2014614146
Associated Practice Facility / Clinic
🏢 Spini Sol Levante Pc Facility NPI 1669525531

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Fort Lee, NJ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 45.0 Yrs
State Avg: 35.6 Yrs
Regional Practice Density
11 Specialists

Practicing in Fort Lee, NJ (1802 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License NJ 25MA02573000

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
Shana Lazar , MA CCC-SLP

Speech-Language Pathologist

NPI 1104067875

MACCCSLP

NPI 1144543661

Registered Pharmacist

NPI 1386280519

Doctor of Naturopathic Medicine, Master of Science

NPI 1710962949

Doctor of Chiropractic

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 10, 2021

Record deactivated on June 10, 2021

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 1600 PARKER AVE, FORT LEE, NJ 070247050 (Tel: 2014612507)

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Updated Business Mailing Address July 08, 2007

Registered at 1600 PARKER AVE, FORT LEE, NJ 070247050 (Tel: 2014612507)

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Provider Name / Credentials Updated July 08, 2007

Recorded as DEANE PENN, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Specialist (License #25MA02573000 in NJ)

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Initial NPI Registration & Enumeration February 10, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1669445557
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 10, 2006
Last Update: July 08, 2007
Deactivation Date: June 10, 2021

Mailing Address

1600 Parker Ave

Fort Lee, NJ 070247050

Phone: 2014612507

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.