1124291893 NPI number — MEENAKSHI KUKREJA M D P A

Table of content: (NPI 1124291893)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124291893 NPI number — MEENAKSHI KUKREJA M D P A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEENAKSHI KUKREJA M D P A
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1124291893
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/29/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
35-37 PROGRESS ST
Provider Second Line Business Mailing Address:
SUITE B5
Provider Business Mailing Address City Name:
EDISON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08820-1179
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-755-0550
Provider Business Mailing Address Fax Number:
908-755-3323

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
35-37 PROGRESS ST
Provider Second Line Business Practice Location Address:
SUITE B5
Provider Business Practice Location Address City Name:
EDISON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08820-1179
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-755-0550
Provider Business Practice Location Address Fax Number:
908-755-3323
Provider Enumeration Date:
04/02/2008

Additional Information

Authorized Official

Authorized Official Last Name:
KUKREJA
Authorized Official First Name:
MEENAKSHI
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
908-755-0550

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X , with the licence number:  25MA03869900 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP2300X , with the licence number: 25MA03869900 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR0400X , with the licence number: 25MA03869900 , 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: 10327 . This is a "UNIVERSITY HEALTH PLANS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 3245608 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 529210 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 23269 . This is a "ENGINEERS LOCAL 825" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 18223 . This is a "AMERIGROUP" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 754356 . This is a "MAIL HANDLERS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 40856 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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