1598034001 NPI number — JEFFREY P. ORLIKOWSKI D.C.,P.A.

Table of content: (NPI 1598034001)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598034001 NPI number — JEFFREY P. ORLIKOWSKI D.C.,P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JEFFREY P. ORLIKOWSKI D.C.,P.A.
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:
1598034001
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/29/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
414 35TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
UNION CITY
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07087-3951
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-864-6666
Provider Business Mailing Address Fax Number:
201-864-9336

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
414 35TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UNION CITY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07087-3951
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-864-6666
Provider Business Practice Location Address Fax Number:
201-864-9336
Provider Enumeration Date:
12/29/2011

Additional Information

Authorized Official

Authorized Official Last Name:
ORLIKOWSKI
Authorized Official First Name:
MARIA
Authorized Official Middle Name:
E
Authorized Official Title or Position:
SECRETARY
Authorized Official Telephone Number:
201-864-6666

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  38MC00399600 , 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: 661202 . This is a "OPTUM HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 670912 . This is a "MEDICARE ID" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 350055659 . This is a "PALMETTO GBA RAILROAD MEDICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 4410188 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 12285150 . This is a "CAQH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 4843100 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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