1033236617 NPI number — HYPERTENSION AND RENAL GROUP, P.A.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033236617 NPI number — HYPERTENSION AND RENAL GROUP, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HYPERTENSION AND RENAL GROUP, 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:
1033236617
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/02/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22 OLD SHORT HILLS RD
Provider Second Line Business Mailing Address:
SUITE 212
Provider Business Mailing Address City Name:
LIVINGSTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07039-5604
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-994-4550
Provider Business Mailing Address Fax Number:
973-994-7085

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
22 OLD SHORT HILLS RD
Provider Second Line Business Practice Location Address:
SUITE 212
Provider Business Practice Location Address City Name:
LIVINGSTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07039-5604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-994-4550
Provider Business Practice Location Address Fax Number:
973-994-7085
Provider Enumeration Date:
03/26/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SIPZNER
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
J
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
973-994-4550

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2812401 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".