1033159249 NPI number — JOHN K MUKAI M.D.

Table of content: JOHN K MUKAI M.D. (NPI 1033159249)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033159249 NPI number — JOHN K MUKAI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MUKAI
Provider First Name:
JOHN
Provider Middle Name:
K
Provider Name Prefix Text:
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:
1033159249
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/31/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14 RICE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TEMPLETON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01468-1332
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-939-2035
Provider Business Mailing Address Fax Number:
978-939-2039

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14 RICE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TEMPLETON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01468-1332
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-939-2035
Provider Business Practice Location Address Fax Number:
978-939-2039
Provider Enumeration Date:
06/07/2006

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: 2085R0202X , with the licence number:  48083 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2085N0700X , with the licence number: 48083 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 754141 . This is a "TUFTS HEALTH PLANS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 042477296 . This is a "HEALTH CARE VALUE MANAGEM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 300072285 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 3011097 . This is a "HEALTHY START" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 52277 . This is a "FALLON COMMUNITY HEALTH" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 97653204 . This is a "NETWORK HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0007041 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 40007 . This is a "HEALTH NEW ENGLAND" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 042477296 . This is a "PRIVATE HEALTH CARE SYSTE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 245374 . This is a "HARVARD PILGRIM HEALTH CA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: J05768 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 3011097 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 684010 . This is a "CIGNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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