Provider Demographics
NPI:1083951826
Name:ADVANCED NEPHROLOGY & HYPERTENSION, LLC
Entity Type:Organization
Organization Name:ADVANCED NEPHROLOGY & HYPERTENSION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ELEEN
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:862-260-9014
Mailing Address - Street 1:26 MADISON AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-7310
Mailing Address - Country:US
Mailing Address - Phone:862-260-9014
Mailing Address - Fax:973-455-1219
Practice Address - Street 1:26 MADISON AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7310
Practice Address - Country:US
Practice Address - Phone:862-260-9014
Practice Address - Fax:973-455-1219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-14
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06536900207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ789030302Medicaid
NJ789030302Medicaid
F04040Medicare UPIN