1548256738 NPI number — DR. MILIND M VAZE M.D.

Table of content: DR. MILIND M VAZE M.D. (NPI 1548256738)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548256738 NPI number — DR. MILIND M VAZE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VAZE
Provider First Name:
MILIND
Provider Middle Name:
M
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:
1548256738
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/11/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
727 WELSH RD
Provider Second Line Business Mailing Address:
SUITE-101
Provider Business Mailing Address City Name:
HUNTINGDON VALLEY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19006-6357
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-914-0600
Provider Business Mailing Address Fax Number:
215-914-0115

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
727 WELSH RD
Provider Second Line Business Practice Location Address:
SUITE-101
Provider Business Practice Location Address City Name:
HUNTINGDON VALLEY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19006-6357
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-914-0600
Provider Business Practice Location Address Fax Number:
215-914-0115
Provider Enumeration Date:
09/22/2005

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: 207RG0100X , with the licence number:  MD051961L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2566127 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0014786810006 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1765000 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 6516 . This is a "BRAVO ELDERHEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1015102 . This is a "KEYSTONE MERCY HEALTH PLA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 5830472 . This is a "CIGNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 71206 . This is a "ADVANTRA FREEMAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: PHS586 . This is a "OXFORD HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0147868112 . This is a "AMERICHOICE OF PA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0709701000 . This is a "IBC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 19194 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 766011 . This is a "BC BS OF PA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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