1518929272 NPI number — NILESH M DOSHI MD

Table of content: NILESH M DOSHI MD (NPI 1518929272)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518929272 NPI number — NILESH M DOSHI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DOSHI
Provider First Name:
NILESH
Provider Middle Name:
M
Provider Name Prefix Text:
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:
1518929272
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1710
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VOORHEES
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08043-7710
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-770-0504
Provider Business Mailing Address Fax Number:
856-751-0535

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
901 ROUTE 168
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TURNERSVILLE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08012-3210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-374-4131
Provider Business Practice Location Address Fax Number:
856-751-0535
Provider Enumeration Date:
04/06/2006

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: 2085R0202X , with the licence number:  25MA06745200 , 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: 5336652 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 60022793 . This is a "HORIZON NJ HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0273456000 . This is a "AMERIHEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1396272 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1737251 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7611501 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10655215 . This is a "CAQH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 382556 . This is a "HIGHMARK PA BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00332784 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: A3738029 . This is a "OXFORD HEALTH" identifier . This identifiers is of the category "OTHER".




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