1033297155 NPI number — DR. RALPH G DEL NEGRO D.O.

Table of content: DR. RALPH G DEL NEGRO D.O. (NPI 1033297155)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033297155 NPI number — DR. RALPH G DEL NEGRO D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DEL NEGRO
Provider First Name:
RALPH
Provider Middle Name:
G
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033297155
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/02/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1809 CORLIES AVENUE
Provider Second Line Business Mailing Address:
SUITE 1
Provider Business Mailing Address City Name:
NEPTUNE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07753-4801
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-774-5566
Provider Business Mailing Address Fax Number:
732-988-7574

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1809 CORLIES AVENUE
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
NEPTUNE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07753-4801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-774-5566
Provider Business Practice Location Address Fax Number:
732-988-7574
Provider Enumeration Date:
11/02/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  25MB05612700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4254343 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 08-02224 . This is a "EVERCARE/ERICKSON" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3L4320 . This is a "EMPIRE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5251702 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: OK1931 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".