1417963505 NPI number — DR. RICHARD A MOJARES M.D.

Table of content: DR. RICHARD A MOJARES M.D. (NPI 1417963505)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417963505 NPI number — DR. RICHARD A MOJARES M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOJARES
Provider First Name:
RICHARD
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1417963505
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/25/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1910 ROUTE 35 SOUTH
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OAKHURST
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07755-2715
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-531-0100
Provider Business Mailing Address Fax Number:
732-531-0144

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1910 ROUTE 35 SOUTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKHURST
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07755-2715
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-531-0100
Provider Business Practice Location Address Fax Number:
732-531-0144
Provider Enumeration Date:
07/31/2006

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: 207R00000X , with the licence number:  MA72134 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208000000X , with the licence number: MA72134 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 222356548 . This is a "BEECHSTREET CORPORATION" identifier . This identifiers is of the category "OTHER".
  • Identifier: 222356548 . This is a "HEALTHNETWORK AMERICA" identifier . This identifiers is of the category "OTHER".
  • Identifier: P3385957 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 222356548 . This is a "GEHA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 222356548 . This is a "NEW JERSEY CARPENTERS FUN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 222356548 . This is a "QUALCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2K3697 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7070451 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2105210 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 222356548 . This is a "OPERATING ENGINEERS LOCAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 222356548 . This is a "PHCS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2235553 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9008900 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3310293 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 222356548 . This is a "FIRST MANAGED CARE OPTION" identifier . This identifiers is of the category "OTHER".
  • Identifier: 222356548 . This is a "CHN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 222356548 . This is a "ST BARNABAS SYSTEM HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: K6311 . This is a "HORIZON BLUE CROSS BLUE S" identifier . This identifiers is of the category "OTHER".




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