Provider Demographics
NPI:1164532909
Name:JIMENEZ, ARTURO D (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTURO
Middle Name:D
Last Name:JIMENEZ
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 1:278 RECTOR ST
Mailing Address - Street 2:
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861-4435
Mailing Address - Country:US
Mailing Address - Phone:732-900-6490
Mailing Address - Fax:732-826-1108
Practice Address - Street 1:86 NEW BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-2242
Practice Address - Country:US
Practice Address - Phone:732-826-1881
Practice Address - Fax:732-826-1108
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07280100174400000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00823265OtherRR MEDICARE
NJ8723109Medicaid
NJP00823265OtherRR MEDICARE
NJ052069Medicare ID - Type Unspecified
NJH50441Medicare UPIN
NJ8723109Medicaid