1174973267 NPI number — UNIVERSITY MEDICAL CENTER MEDICAL CENTER IN PLAINSBORO

Table of content: DR. LEENA YAQOO ATISHA DDS (NPI 1891680377)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174973267 NPI number — UNIVERSITY MEDICAL CENTER MEDICAL CENTER IN PLAINSBORO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY MEDICAL CENTER MEDICAL CENTER IN PLAINSBORO
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:
1174973267
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/20/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
522 EDISON GLEN TER
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EDISON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08837-2927
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-407-0401
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 PLAINSBORO RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLAINSBORO
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08536-1913
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-407-0401
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/20/2016

Additional Information

Authorized Official

Authorized Official Last Name:
LEE
Authorized Official First Name:
BETTY
Authorized Official Middle Name:
Authorized Official Title or Position:
ADVANCE PRACTICE NURSE
Authorized Official Telephone Number:
732-407-0401

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  26NJ00356500 , 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)





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