1609427954 NPI number — KADEN MEDICAL OF NEW JERSEY, P.C.

Table of content: (NPI 1609427954)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609427954 NPI number — KADEN MEDICAL OF NEW JERSEY, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KADEN MEDICAL OF NEW JERSEY, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1609427954
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/08/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
205 EAST 42ND STREET, 15TH FLOOR
Provider Second Line Business Mailing Address:
C/O KADEN HEALTH, INC.
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10017-5323
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-650-8891
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 GATEWAY CTR FL 13
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07102-5323
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-885-2336
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/26/2019

Additional Information

Authorized Official

Authorized Official Last Name:
DELGIUDICE
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/FOUNDER
Authorized Official Telephone Number:
603-533-1873

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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