1528079290 NPI number — UDAY SITAKANT KUNTE MD

Table of content: UDAY SITAKANT KUNTE MD (NPI 1528079290)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528079290 NPI number — UDAY SITAKANT KUNTE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KUNTE
Provider First Name:
UDAY
Provider Middle Name:
SITAKANT
Provider Name Prefix Text:
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:
1528079290
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/21/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1203 LANGHORNE NEWTOWN RD STE 226
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LANGHORNE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19047-1224
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-752-3330
Provider Business Mailing Address Fax Number:
215-752-3036

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1226 LINDEN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YARDLEY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19067-7416
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-752-3330
Provider Business Practice Location Address Fax Number:
215-752-3036
Provider Enumeration Date:
08/10/2006

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: 208600000X , with the licence number:  MA03803900 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: MD038887L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2708734003 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0021833000 . This is a "KEYSTONE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1018901 . This is a "HORIZON NJ HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 34162 . This is a "US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 880194494 . This is a "HORIZON" identifier . This identifiers is of the category "OTHER".
  • Identifier: ME000006900 . This is a "AMERICHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: BU5237 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4057201 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 880194494 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".