1831166925 NPI number — STEPHEN SHERER MD PA

Table of content: (NPI 1831166925)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831166925 NPI number — STEPHEN SHERER MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STEPHEN SHERER MD PA
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:
1831166925
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
714 BERGEN BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RIDGEFIELD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07657-1425
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-945-0521
Provider Business Mailing Address Fax Number:
201-945-5604

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
714 BERGEN BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RIDGEFIELD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07657-1425
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-945-0521
Provider Business Practice Location Address Fax Number:
201-945-5604
Provider Enumeration Date:
03/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SHERER
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
BARRY
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
201-945-6641

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  37042 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X , with the licence number: 37042 , 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: 0400512 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 412574 . This is a "CIGNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: SS038A2710 . This is a "EMPIRE BC/BS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: OK2402 . This is a "HEALTHNET" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0037742 . This is a "GROUP HEALTH INC" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 134385421 . This is a "TRICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: BS470 . This is a "OXFORD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0092076000 . This is a "AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 41349 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 436208 . This is a "CIGNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 514069 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0092076002 . This is a "AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 060065908 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1053604 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com