Provider Demographics
NPI:1164860631
Name:JOSE PINAL, M.D., P.C.
Entity Type:Organization
Organization Name:JOSE PINAL, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:PINAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-865-9195
Mailing Address - Street 1:526 42ND ST
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-2989
Mailing Address - Country:US
Mailing Address - Phone:201-865-9195
Mailing Address - Fax:201-865-4416
Practice Address - Street 1:526 42ND ST
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-2989
Practice Address - Country:US
Practice Address - Phone:201-865-9195
Practice Address - Fax:201-865-4416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-06
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03550000207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3226808Medicaid
NJ3226808Medicaid