1376598136 NPI number — YELENA BIRGER MD

Table of content: YELENA BIRGER MD (NPI 1376598136)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376598136 NPI number — YELENA BIRGER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BIRGER
Provider First Name:
YELENA
Provider Middle Name:
Provider Name Prefix Text:
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:
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:
1376598136
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/13/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12 WALDEN CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OLD BRIDGE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08857-3573
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-360-0619
Provider Business Mailing Address Fax Number:
732-333-0004

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 CRAIG RD
Provider Second Line Business Practice Location Address:
SUITE 208
Provider Business Practice Location Address City Name:
MANALAPAN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07726-8742
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-333-0062
Provider Business Practice Location Address Fax Number:
732-333-0004
Provider Enumeration Date:
05/23/2006

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: 207RA0000X , with the licence number:  226826 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 25MB07663700 , 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: 02389839 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com