1235146705 NPI number — RICHARD B MUNCASTER MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235146705 NPI number — RICHARD B MUNCASTER MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

MUNCASTER

Provider First Name:

RICHARD

Provider Middle Name:

B

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

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:

1235146705

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

05/05/2008

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

3 COOPER PLZ

Provider Second Line Business Mailing Address:

SUITE 502

Provider Business Mailing Address City Name:

CAMDEN

Provider Business Mailing Address State Name:

NJ

Provider Business Mailing Address Postal Code:

08103-1438

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

856-968-7433

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

2 PLAZA DR

Provider Second Line Business Practice Location Address:

BUNKER HILL PLAZA

Provider Business Practice Location Address City Name:

SEWELL

Provider Business Practice Location Address State Name:

NJ

Provider Business Practice Location Address Postal Code:

08080-9207

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

856-270-4150

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

08/01/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 208800000X , with the licence number:  MD429266 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 208800000X , with the licence number: MA04835800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 1636598 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 2162976 . This is a "CIGNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 2862291000 . This is a "AMERIHEALTH/KEYSTONE/IBC" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: P00455951 . This is a "RR MEDICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 01004599500 . This is a "AMERICHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 1984555 . This is a "PA BS HIGHMARK" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 3K7718 . This is a "HEALTHNET" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 60034127 . This is a "HORIZON NJ HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: P3838995 . This is a "OXFORD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 0142387 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
• Identifier: 1735957 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".