Provider Demographics
NPI:1255312054
Name:JANSONS, ULDIS J (MD)
Entity Type:Individual
Prefix:DR
First Name:ULDIS
Middle Name:J
Last Name:JANSONS
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 1:115 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-2205
Mailing Address - Country:US
Mailing Address - Phone:908-850-0150
Mailing Address - Fax:
Practice Address - Street 1:115 CHURCH ST
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-2205
Practice Address - Country:US
Practice Address - Phone:908-850-0150
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03097200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1079701Medicaid
NJC53506Medicare UPIN
NJ140414Medicare ID - Type Unspecified