Provider Demographics
NPI:1235107301
Name:JAIN, ARCHNA (MD)
Entity Type:Individual
Prefix:
First Name:ARCHNA
Middle Name:
Last Name:JAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1138 E CHESTNUT AVE
Mailing Address - Street 2:#5B
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-5062
Mailing Address - Country:US
Mailing Address - Phone:856-692-1108
Mailing Address - Fax:856-692-2077
Practice Address - Street 1:1138 E CHESTNUT AVE
Practice Address - Street 2:#5B
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-5062
Practice Address - Country:US
Practice Address - Phone:856-692-1108
Practice Address - Fax:856-692-2077
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA48345208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
10915OtherAETNA HMO
2600641OtherGROUP HEALTH INC
NJ3847209Medicaid
1043194OtherHORIZON NJ HEALTH
35560OtherUNIVERSITY HEALTH CARE
1000202800OtherAMERICHOICE
3847209OtherAMERIGROUP
J5558OtherBLUE SHIELD NJ HMO
NJ1018OtherBLUE SHIELD OF DELAWARE
440297000OtherAMERIHEALTH
1325521OtherFIRST HEALTH GROUP CORP
4104693OtherAETNA MANAGED CARE
4131540OtherCIGNA
78K411OtherBLUE SHIELD OF NY EMPIRE
F09359OtherPHYSICIANS HEALTH
P391706OtherOXFORD HEALTH PLANS
1043194OtherHORIZON NJ HEALTH
440297000OtherAMERIHEALTH