1295872349 NPI number — DR. VERONICA MARIE BIKOFSKY DMD

Table of content: DR. VERONICA MARIE BIKOFSKY DMD (NPI 1295872349)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295872349 NPI number — DR. VERONICA MARIE BIKOFSKY DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BIKOFSKY
Provider First Name:
VERONICA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
F

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:
1295872349
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/12/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11 RICKLAND RD.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PARSIPPANY
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07054
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-732-3208
Provider Business Mailing Address Fax Number:
973-732-3207

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 LYONS AVE.
Provider Second Line Business Practice Location Address:
NEWARK BETH ISRAEL MEDICAL CTR.
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-732-3208
Provider Business Practice Location Address Fax Number:
973-732-3207
Provider Enumeration Date:
01/30/2007

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: 1223G0001X , with the licence number:  NJ 012277 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223G0001X , with the licence number: 012277 , 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: 1034187 . This is a "HORIZON NJ HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0727105 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9175954,162860 . This is a "DORAL" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: D00000530.00 . This is a "AMERICHOICE" identifier . This identifiers is of the category "OTHER".




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