1336237932 NPI number — OLGA BYALIK MD PC

Table of content: (NPI 1336237932)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336237932 NPI number — OLGA BYALIK MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OLGA BYALIK MD PC
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:
1336237932
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1247
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRINGFIELD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07081
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-467-0963
Provider Business Mailing Address Fax Number:
973-467-5385

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
90 RT 22W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07081
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-467-0963
Provider Business Practice Location Address Fax Number:
973-467-5385
Provider Enumeration Date:
10/10/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BYALIK
Authorized Official First Name:
OLGA
Authorized Official Middle Name:
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
973-467-0963

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0297016 . This is a "GHI" identifier . This identifiers is of the category "OTHER".
  • Identifier: P2491211 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2K7792 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".