1235188798 NPI number — DR. STEPHEN H URETSKY MD

Table of content: DR. STEPHEN H URETSKY MD (NPI 1235188798)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235188798 NPI number — DR. STEPHEN H URETSKY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
URETSKY
Provider First Name:
STEPHEN
Provider Middle Name:
H
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1235188798
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/15/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2021 NEW ROAD
Provider Second Line Business Mailing Address:
STE 6
Provider Business Mailing Address City Name:
LINWOOD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08221
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-927-3373
Provider Business Mailing Address Fax Number:
609-927-4041

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2021 NEW ROAD
Provider Second Line Business Practice Location Address:
STE 6
Provider Business Practice Location Address City Name:
LINWOOD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08221
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-927-3373
Provider Business Practice Location Address Fax Number:
609-927-4041
Provider Enumeration Date:
05/10/2006

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:  MA42134 , 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: 086183 . This is a "EMPIRE MEDICARE GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 201612829 . This is a "AARP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2345288000 . This is a "AMERIHEALTH GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2K7902 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3124207 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3724882 . This is a "AETNA GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00175889 . This is a "RR MEDICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0116830000 . This is a "AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 206038 . This is a "US FAMILY HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 542685 . This is a "PA BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 542685 . This is a "AMERIHEALTH ADMIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 999187 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 201612829 . This is a "HUMANA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3724613 . This is a "AETNA INDIVIDUAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: NJ0004637 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: P11047015 . This is a "MULTIPLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: P382155 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 201612829 . This is a "HORIZON BCBS" identifier . This identifiers is of the category "OTHER".




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