1447255898 NPI number — DR. UMESH KATDARE M.D.

Table of content: DR. UMESH KATDARE M.D. (NPI 1447255898)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447255898 NPI number — DR. UMESH KATDARE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KATDARE
Provider First Name:
UMESH
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1447255898
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/02/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2566
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GUTTENBERG
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07093-0641
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-854-0055
Provider Business Mailing Address Fax Number:
201-854-2633

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
425 70TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GUTTENBERG
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07093-2417
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-854-0055
Provider Business Practice Location Address Fax Number:
201-854-2633
Provider Enumeration Date:
06/14/2005

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: 207RI0011X , with the licence number:  MA071684 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RI0011X , with the licence number: 25MA07168400 , 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: 3614421 . This is a "AETNA HMO #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P00174451 . This is a "RAILROAD MDCR #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2K8700 . This is a "HEALTHNET #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 612Q12 . This is a "EMPIRE BC/BS NEWARK #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 8221517 . This is a "GHI ID #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P3389564 . This is a "OXFORD #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0036331 . This is a "MEDICAID ID #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 01000676400 . This is a "AMERICHOICE ID #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 612Q13 . This is a "EMPIRE BC/BS SECAUCUS #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 40570 . This is a "UNIVERSITY HEALTH PLANS #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 612Q11 . This is a "EMPIRE BC/BS GUTTENBERG #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0036331 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2394424000 . This is a "AMERIHEALTH ID #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 7307613 . This is a "AETNA PPO #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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