1861432684 NPI number — DR. NORAYR OZBALIK D.C.

Table of content: (NPI 1831290345)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861432684 NPI number — DR. NORAYR OZBALIK D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OZBALIK
Provider First Name:
NORAYR
Provider Middle Name:
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:
1861432684
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/24/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3840 PARK AVE
Provider Second Line Business Mailing Address:
SUITE D108
Provider Business Mailing Address City Name:
EDISON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08820-2563
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-902-2302
Provider Business Mailing Address Fax Number:
732-902-2305

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3840 PARK AVE
Provider Second Line Business Practice Location Address:
SUITE D108
Provider Business Practice Location Address City Name:
EDISON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08820-2563
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-902-2302
Provider Business Practice Location Address Fax Number:
732-902-2305
Provider Enumeration Date:
06/08/2006

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:  MC04226 , 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: 20820140000 . This is a "AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0066109 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 217333 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2381661 . This is a "AETNA US HEALTHCARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P1885364 . This is a "OXFORD HEALTH PLAN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: X8Z38 . This is a "WELLCHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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