1972544815 NPI number — DR. GAMIL LAMEY MAKAR M.D

Table of content: TRINITY RUTERBORIES (NPI 1437911013)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972544815 NPI number — DR. GAMIL LAMEY MAKAR M.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAKAR
Provider First Name:
GAMIL
Provider Middle Name:
LAMEY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D
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:
1972544815
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/06/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1700 ROUTE 3 WEST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLIFTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
862-249-4901
Provider Business Mailing Address Fax Number:
973-928-2650

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1700 ROUTE 3 WEST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLIFTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
862-249-4901
Provider Business Practice Location Address Fax Number:
973-928-2650
Provider Enumeration Date:
06/10/2006

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: 207QG0300X , with the licence number:  25MA07631500 , 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: 0024546 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8221833 . This is a "GHI-PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2373594000 . This is a "AMERIHEALTH-PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 60023390 . This is a "HORIZON NJ HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 01000663401 . This is a "AMERICHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2K7621 . This is a "HEALTHNET" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P3346585 . This is a "OXFORD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P00183900 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2373594000 . This is a "KEYSTONE HEALTHPLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 355853 . This is a "MANAGED HEALTH NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9751982 . This is a "GHI-HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2367766000 . This is a "AMERIHEALTH-HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7792567 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".




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