1770568610 NPI number — DR. ARUNA SURESHBHAI PATEL M.D. LLC.

Table of content: DR. ARUNA SURESHBHAI PATEL M.D. LLC. (NPI 1770568610)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770568610 NPI number — DR. ARUNA SURESHBHAI PATEL M.D. LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PATEL
Provider First Name:
ARUNA
Provider Middle Name:
SURESHBHAI
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D. LLC.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PATEL
Provider Other First Name:
ARUNA
Provider Other Middle Name:
S
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D LLC.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1770568610
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
725 N BROAD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELIZABETH
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07208-2347
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-351-8989
Provider Business Mailing Address Fax Number:
908-351-8879

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
725 N BROAD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELIZABETH
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07208-2347
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-351-8989
Provider Business Practice Location Address Fax Number:
908-351-8879
Provider Enumeration Date:
12/14/2005

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: 207Q00000X , with the licence number:  25MA03684700 , 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: 0028598 . This is a "GHI" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1044481 . This is a "HORIZON N.J. HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 01000020700 . This is a "AMERICHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 11045 . This is a "UNIVERSITY HEALTH PLANS," identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 222328190-001 . This is a "QUALCARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 469006 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 156267 . This is a "ONE HEALTH PLAN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 010000207 00 . This is a "AMERICHOICE PERSONAL CARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0112022001 . This is a "AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 153412 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 3834701 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3839701 . This is a "AMERIGROUP" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0004117590 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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