1902981152 NPI number — CLAUDE ABOUCHEDID MD

Table of content: CLAUDE ABOUCHEDID MD (NPI 1902981152)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902981152 NPI number — CLAUDE ABOUCHEDID MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ABOUCHEDID
Provider First Name:
CLAUDE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
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:
1902981152
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/24/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1542 KUSER RD
Provider Second Line Business Mailing Address:
SUITE B3
Provider Business Mailing Address City Name:
TRENTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08619-3829
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-585-2323
Provider Business Mailing Address Fax Number:
609-585-0625

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1542 KUSER RD
Provider Second Line Business Practice Location Address:
SUITE B3
Provider Business Practice Location Address City Name:
TRENTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08619-3829
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-585-2323
Provider Business Practice Location Address Fax Number:
609-585-0625
Provider Enumeration Date:
10/26/2006

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: 208600000X , with the licence number:  MA25083 , 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: F03153 . This is a "HEALTHNET" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1039639 . This is a "HORIZON MERCY" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0086193000 . This is a "KEYSTONE HPE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0730555000 . This is a "AMERIHEALTH HMO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 166969 . This is a "PABS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: ME212 . This is a "OXFORD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1436698 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0086193000 . This is a "AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1739506 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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