1518050129 NPI number — DR. BARBARA J EVANS MD

Table of content: DR. BARBARA J EVANS MD (NPI 1518050129)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518050129 NPI number — DR. BARBARA J EVANS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EVANS
Provider First Name:
BARBARA
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1518050129
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/03/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
36 KNICKERBOCKER DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLE MEAD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08502-4544
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-915-4318
Provider Business Mailing Address Fax Number:
609-915-4318

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
36 KNICKERBOCKER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLE MEAD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08502-4544
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-915-4318
Provider Business Practice Location Address Fax Number:
908-874-3397
Provider Enumeration Date:
10/02/2006

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: 2080P0008X , with the licence number:  MA30683 , 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: 4880501 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1011459 . This is a "HORIZON NJ HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: CA0000150 . This is a "AMERICHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P668427 . This is a "OXFORD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0073793000 . This is a "AMERIHEALTH/KEYSTONE/IBC" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2969170 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 42656 . This is a "AMERIHEALTH PPO/PA BS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 3K5450 . This is a "HEALTHNET, INC" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 9203212 . This is a "CIGNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1242590 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 13559 . This is a "UNIVERSITY HEALTH PLAN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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