1659385144 NPI number — ROBERT A DONOHUE III MD

Table of content: ROBERT A DONOHUE III MD (NPI 1659385144)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659385144 NPI number — ROBERT A DONOHUE III MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DONOHUE
Provider First Name:
ROBERT
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
III
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:
1659385144
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/11/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1262 WHITEHORSE HAMILTON SQUARE RD
Provider Second Line Business Mailing Address:
STE 2B
Provider Business Mailing Address City Name:
HAMILTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08690-3711
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-585-9595
Provider Business Mailing Address Fax Number:
609-585-9444

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1262 WHITEHORSE HAMILTON SQUARE RD
Provider Second Line Business Practice Location Address:
STE 2B
Provider Business Practice Location Address City Name:
HAMILTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08690-3711
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-585-9595
Provider Business Practice Location Address Fax Number:
609-585-9444
Provider Enumeration Date:
07/28/2006

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: 207W00000X , with the licence number:  MA049912 , 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: 57451 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 223486084 . This is a "HMO BLUE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 985408 . This is a "PHS" identifier . This identifiers is of the category "OTHER".
  • Identifier: D0452274 . This is a "INDEPENDENCE BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1435994 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0209045000 . This is a "KEYSTONE AMERIHEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: F14593 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: F14593 . This is a "PHCS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1243732005 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: ME5287 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".




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