Provider Demographics
NPI:1114113891
Name:PATHARKAR, MILIND DINKAR (MD)
Entity Type:Individual
Prefix:DR
First Name:MILIND
Middle Name:DINKAR
Last Name:PATHARKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 EIGHTH ST.
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037
Mailing Address - Country:US
Mailing Address - Phone:888-985-2727
Mailing Address - Fax:609-567-8832
Practice Address - Street 1:2 EIGHTH STREET
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037
Practice Address - Country:US
Practice Address - Phone:888-985-2727
Practice Address - Fax:609-567-8832
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-17
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08195200207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ123428X5TMedicare UPIN
NJ123428X8NMedicare PIN
NJP00600783Medicare PIN