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NORTH HALEDON MEDICAL PC NPI 1477624088


NPI Information

NPI: 1477624088
Provider Name: NORTH HALEDON MEDICAL, PC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
510 HAMBURG TPKE
WAYNE COMMONS, SUITE 101
WAYNE, NJ
ZIP 07470
Phone: (973) 942-6005
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NORTH HALEDON MEDICAL, PC is a specialist in Wayne, NJ. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. NORTH HALEDON MEDICAL, PC NPI is 1477624088. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

510 HAMBURG TPKE
WAYNE COMMONS, SUITE 101
WAYNE, NJ
ZIP 07470-025
Phone: (973) 942-6005
Fax: (973) 942-6009

The provider's authorized official is Anthony Barravecchio .
The authorized official title is Delegated Official and has the following contact phone number (973) 942-6005.

The enumeration date for this NPI number is 11/13/2006 and was last updated on 4/4/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist25MB06978600NEW JERSEYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12016615002OTHERNEW JERSEYAMERIHEALTH GROUP #
27305262OTHERNEW JERSEYAETNA GROUP #
38644101MEDICAIDNEW JERSEY
4048963MEDICARE PINNEW JERSEY
5=========OTHERNEW JERSEYTAX ID#
6DC3972OTHERNEW JERSEYRAILROAD MDCR GROUP #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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