1477537769 NPI number — DR. IVAN LENDVAI MD

Table of content: DR. IVAN LENDVAI MD (NPI 1477537769)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477537769 NPI number — DR. IVAN LENDVAI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LENDVAI
Provider First Name:
IVAN
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1477537769
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/21/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
671 HOES LN W
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PISCATAWAY
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08854-8021
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-235-3289
Provider Business Mailing Address Fax Number:
732-235-4485

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4326 US ROUTE 1 N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONMOUTH JUNCTION
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08852
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-235-5910
Provider Business Practice Location Address Fax Number:
732-235-5644
Provider Enumeration Date:
12/01/2005

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: 2084P0800X , with the licence number:  200070 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X , with the licence number: 25MA06141800 , 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: 01765504 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 31-4011 . This is a "UBHC MEDICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 260044578 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4144007 . This is a "MEDICAID UBHC" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P00602034 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: DN0541 . This is a "RAILROAD MEDICARE GRP. #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com