1255589966 NPI number — R & R PERINATAL ASSOCIATES

Table of content: (NPI 1255589966)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255589966 NPI number — R & R PERINATAL ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
R & R PERINATAL ASSOCIATES
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:
1255589966
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
228 PARK AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOBOKEN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07030-3794
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-996-2943
Provider Business Mailing Address Fax Number:
201-336-8112

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20 PROSPECT AVE
Provider Second Line Business Practice Location Address:
SUITE 601
Provider Business Practice Location Address City Name:
HACKENSACK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07601-1997
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-996-2943
Provider Business Practice Location Address Fax Number:
201-336-8112
Provider Enumeration Date:
09/05/2008

Additional Information

Authorized Official

Authorized Official Last Name:
ALVAREZ
Authorized Official First Name:
MANUEL
Authorized Official Middle Name:
Authorized Official Title or Position:
CHAIRMAN OF MATERNAL FETAL MEDICINE
Authorized Official Telephone Number:
201-996-2943

Provider Taxonomy Codes

  • Taxonomy code: 207VM0101X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 165114-1 . This is a "LICENSE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: MA04343800 . This is a "LINCENSE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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