Provider Demographics
NPI:1073739900
Name:URGENTMED, PC
Entity Type:Organization
Organization Name:URGENTMED, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:J
Authorized Official - Last Name:KALADAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-560-1234
Mailing Address - Street 1:141 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH BOUND BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08880-1480
Mailing Address - Country:US
Mailing Address - Phone:732-560-1234
Mailing Address - Fax:732-560-1749
Practice Address - Street 1:141 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTH BOUND BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08880-1480
Practice Address - Country:US
Practice Address - Phone:732-560-1234
Practice Address - Fax:732-560-1749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA 61660207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG04910Medicare UPIN
NJ722717Medicare PIN