Provider Demographics
NPI:1225064942
Name:CONSULTANTS IN KIDNEY DISEASES PA
Entity Type:Organization
Organization Name:CONSULTANTS IN KIDNEY DISEASES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZAKARIA
Authorized Official - Middle Name:W
Authorized Official - Last Name:MANIYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-890-9111
Mailing Address - Street 1:2333 WHITEHORSE MERCERVILLE RD
Mailing Address - Street 2:STE 4
Mailing Address - City:MERCERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08619
Mailing Address - Country:US
Mailing Address - Phone:609-890-9111
Mailing Address - Fax:609-890-6865
Practice Address - Street 1:2333 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:STE 4
Practice Address - City:MERCERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08619
Practice Address - Country:US
Practice Address - Phone:609-890-9111
Practice Address - Fax:609-890-6865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA48702207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9116206Medicaid
F01623Medicare UPIN
NJ052494Medicare PIN