Provider Demographics
NPI:1083841407
Name:MED-ONE LLC
Entity Type:Organization
Organization Name:MED-ONE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGSTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:VASANTHI
Authorized Official - Middle Name:
Authorized Official - Last Name:KACHIRAYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-448-1893
Mailing Address - Street 1:3322 RTE 22 STE 806
Mailing Address - Street 2:
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-4406
Mailing Address - Country:US
Mailing Address - Phone:908-448-1893
Mailing Address - Fax:
Practice Address - Street 1:3322 RTE 22 STE 806
Practice Address - Street 2:
Practice Address - City:BRANCHBURG
Practice Address - State:NJ
Practice Address - Zip Code:08876-4406
Practice Address - Country:US
Practice Address - Phone:908-448-1893
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty