1265754105 NPI number — FREDERIQUE DELHAYE M.D. :P.C.

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 1265754105 NPI number — FREDERIQUE DELHAYE M.D. :P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FREDERIQUE DELHAYE M.D. :P.C.
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:
1265754105
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/19/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1626 RTE 130 STE J
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH BRUNSWICK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08902-3035
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-422-4144
Provider Business Mailing Address Fax Number:
732-422-4468

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1626 RT 130 NORTH
Provider Second Line Business Practice Location Address:
SUITE J
Provider Business Practice Location Address City Name:
NORTH BRUNSWICK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08902-3051
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-422-4144
Provider Business Practice Location Address Fax Number:
732-422-4468
Provider Enumeration Date:
02/19/2010

Additional Information

Authorized Official

Authorized Official Last Name:
DELHAYE
Authorized Official First Name:
FREDERIQUE
Authorized Official Middle Name:
P
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
732-422-4144

Provider Taxonomy Codes

  • Taxonomy code: 261QH0100X , with the licence number:  25MA04868500 , 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: 665794 . This is a "PTAN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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