1740250141 NPI number — DR. FLORA BAI MD

Table of content: DR. FLORA BAI MD (NPI 1740250141)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740250141 NPI number — DR. FLORA BAI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BAI
Provider First Name:
FLORA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BAI
Provider Other First Name:
FU
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1740250141
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/07/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23 OAKCREST CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOLMDEL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07733-1162
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
646-872-2900
Provider Business Mailing Address Fax Number:
908-754-4901

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
799 BLOOMFIELD AVENUE STE 212
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VERONA
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07044-1001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-754-4900
Provider Business Practice Location Address Fax Number:
908-754-4901
Provider Enumeration Date:
01/26/2006

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: 207RR0500X , with the licence number:  MA74252 , 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: P3447763 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0015890 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4177F2 . This is a "WELLCHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2590922 . This is a "GHI" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00232095 . This is a "RAIL ROAD MEDICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 364227 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6519536003 . This is a "CIGNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6519536001 . This is a "CIGNA PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2K7102 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".




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