1386774628 NPI number — M H AL - ASHA MD PA

Table of content: (NPI 1386774628)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386774628 NPI number — M H AL - ASHA MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
M H AL - ASHA MD 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:
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:
1386774628
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:
1930 STATE ROUTE 35
Provider Second Line Business Mailing Address:
SUITE 1 ALLAIRE PLAZA
Provider Business Mailing Address City Name:
WALL TOWNSHIP
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07719-3538
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-449-2212
Provider Business Mailing Address Fax Number:
732-974-9888

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1930 STATE ROUTE 35
Provider Second Line Business Practice Location Address:
SUITE 1 ALLAIRE PLAZA
Provider Business Practice Location Address City Name:
WALL TOWNSHIP
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07719-3538
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-449-2212
Provider Business Practice Location Address Fax Number:
732-974-9888
Provider Enumeration Date:
03/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
AL-ASHA
Authorized Official First Name:
MOHAMMAD
Authorized Official Middle Name:
H
Authorized Official Title or Position:
PHYSICAN
Authorized Official Telephone Number:
732-449-2212

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  25MA02970800 , 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: 0023361 . This is a "GHI" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 4121738 . This is a "CIGNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1059441 . This is a "HORIZO MERCY" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 381899 . This is a "FOCUS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0074446000 . This is a "AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0074446001 . This is a "AMERIHEALTH SPECALTY" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0K08156 . This is a "HEALTHNET" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 251124 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 3017303 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 35083 . This is a "EMPIRE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P1495397 . This is a "OXFORD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 4112035 . This is a "AETNA US HEALTHCARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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