1326191008 NPI number — BRAIT PARTNOW MARGOLIN & SHARETTS MDS PA

Table of content: (NPI 1326191008)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326191008 NPI number — BRAIT PARTNOW MARGOLIN & SHARETTS MDS PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRAIT PARTNOW MARGOLIN & SHARETTS MDS PA
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:
6
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:
1326191008
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/01/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
231 VAN SCIVER PARKWAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILLINGBORO
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08046-1132
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-871-7500
Provider Business Mailing Address Fax Number:
609-871-6026

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
231 VAN SCIVER PARKWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILLINGBORO
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08046-1132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-871-7500
Provider Business Practice Location Address Fax Number:
609-871-6026
Provider Enumeration Date:
01/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PARTNOW
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
609-871-7500

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084N0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 079851 . This is a "PA BLUE SHIELD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 363582900 . This is a "US DEPT OF LABOR W" identifier . This identifiers is of the category "OTHER".
  • Identifier: CN1212 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 007712900 . This is a "AMERIHEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 007712900 . This is a "KEYSTONE HPE" identifier . This identifiers is of the category "OTHER".
  • Identifier: BU000005900 . This is a "AMERICHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0002782 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3099890 . This is a "GHI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 113941900 . This is a "US DEPT OF LABOR M" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0000F02083 . This is a "HEALTH NET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2811901 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1035083 . This is a "HORIZON NJ HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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