1215948989 NPI number — UDAY KUNTE MD FACS

Table of content: (NPI 1215948989)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215948989 NPI number — UDAY KUNTE MD FACS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UDAY KUNTE MD FACS
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:
1215948989
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1445 WHITEHORSE MERCERVILLE RD
Provider Second Line Business Mailing Address:
SUITE 104
Provider Business Mailing Address City Name:
HAMILTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08619
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-528-8864
Provider Business Mailing Address Fax Number:
609-528-8865

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1445 WHITEHORSE MERCERVILLE RD
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
HAMILTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08619
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-528-8864
Provider Business Practice Location Address Fax Number:
609-528-8865
Provider Enumeration Date:
08/10/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KUNTE
Authorized Official First Name:
UDAY
Authorized Official Middle Name:
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
609-528-8864

Provider Taxonomy Codes

  • Taxonomy code: 208600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0021833000 . This is a "KEYSTONE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 34162 . This is a "US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1018901 . This is a "HORIZON NJ HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: BU5237 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2708734003 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4057201 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".