Provider Demographics
NPI:1215014246
Name:AMIN, PINAKIN (MD)
Entity Type:Individual
Prefix:
First Name:PINAKIN
Middle Name:
Last Name:AMIN
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 1:17 CRESTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1946
Mailing Address - Country:US
Mailing Address - Phone:609-601-9765
Mailing Address - Fax:
Practice Address - Street 1:17 CRESTWOOD AVE
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1946
Practice Address - Country:US
Practice Address - Phone:609-601-9765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04740400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ799406QLLMedicare PIN
NJ799406SBVMedicare PIN
NJF53615Medicare UPIN