1487620456 NPI number — USHARANI NATARAJAN M.D.

Table of content: USHARANI NATARAJAN M.D. (NPI 1487620456)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487620456 NPI number — USHARANI NATARAJAN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NATARAJAN
Provider First Name:
USHARANI
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1487620456
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/05/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
81 HARTLEY LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BASKING RIDGE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07920-3707
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-452-4354
Provider Business Mailing Address Fax Number:
973-998-7313

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25 LINDSLEY DR
Provider Second Line Business Practice Location Address:
STE 110
Provider Business Practice Location Address City Name:
MORRISTOWN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07960-4456
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-442-7011
Provider Business Practice Location Address Fax Number:
973-998-7313
Provider Enumeration Date:
02/28/2006

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: 207RI0200X , with the licence number:  25MAO7412000 , 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: 0029262 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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