Provider Demographics
NPI:1366635427
Name:ROBERT A ADAIR M D P A
Entity Type:Organization
Organization Name:ROBERT A ADAIR M D P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ATON
Authorized Official - Last Name:ADAIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-836-7970
Mailing Address - Street 1:699 TEANECK RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4244
Mailing Address - Country:US
Mailing Address - Phone:201-836-7970
Mailing Address - Fax:201-836-7973
Practice Address - Street 1:699 TEANECK RD
Practice Address - Street 2:SUITE 101
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4244
Practice Address - Country:US
Practice Address - Phone:201-836-7970
Practice Address - Fax:201-836-7973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA28168207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1366635427OtherNPI
NJB78318Medicare UPIN
NJ114720Medicare PIN