1538175468 NPI number — DR. STEVEN RICHARD RAY D.C.

Table of content: DR. STEVEN RICHARD RAY D.C. (NPI 1538175468)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538175468 NPI number — DR. STEVEN RICHARD RAY D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAY
Provider First Name:
STEVEN
Provider Middle Name:
RICHARD
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
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:
1538175468
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
194 ABERDEEN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILLIAMSTOWN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08094-2938
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-629-8655
Provider Business Mailing Address Fax Number:
856-629-3909

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
507 WILLIAMSTOWN RD
Provider Second Line Business Practice Location Address:
NEW FREDOM RD
Provider Business Practice Location Address City Name:
SICKLERVILLE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08081-1775
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-629-1199
Provider Business Practice Location Address Fax Number:
856-629-3909
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: 111N00000X , with the licence number:  38MC00304600 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 111N00000X , with the licence number: DC003294L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 0104420000 . This is a "KEYSTONE HMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: R48652 . This is a "HORIZON BC BS NJ PLUS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 119350 . This is a "CORESOURCE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 453169 . This is a "MAILHANDLERS INS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0104420000 . This is a "AMERIHEALTH HMO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1082504 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 192487 . This is a "CHN SOLUTIONS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P500714 . This is a "OXFORD INS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0549376 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 453169 . This is a "NJ CARPENTERS HEALTH FUND" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 6393394 . This is a "CIGNA HEALTH INS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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