1356442909 NPI number — DR. HOWARD J SPERLING MD

Table of content: DR. HOWARD J SPERLING MD (NPI 1356442909)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356442909 NPI number — DR. HOWARD J SPERLING MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SPERLING
Provider First Name:
HOWARD
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1356442909
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/19/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 241
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEEDS POINT
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08220-0241
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-748-8200
Provider Business Mailing Address Fax Number:
609-748-9200

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
162 SOUTH NEW YORK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GALLOWAY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-748-8200
Provider Business Practice Location Address Fax Number:
609-748-9200
Provider Enumeration Date:
09/26/2006

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: 207Q00000X , with the licence number:  MA042924 , 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: 0011215 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 080104104 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".




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