Provider Demographics
NPI:1376580001
Name:NORTH EDISON FAMILY PRACTICE GROUP, LLC
Entity Type:Organization
Organization Name:NORTH EDISON FAMILY PRACTICE GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNAL MEDICINE/NEPHOROLOGY
Authorized Official - Prefix:
Authorized Official - First Name:BIKRAMJIT
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-755-9797
Mailing Address - Street 1:PO BOX 428
Mailing Address - Street 2:
Mailing Address - City:CARTERET
Mailing Address - State:NJ
Mailing Address - Zip Code:07008-0428
Mailing Address - Country:US
Mailing Address - Phone:908-755-9797
Mailing Address - Fax:
Practice Address - Street 1:35-37 PROGRESS ST
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1179
Practice Address - Country:US
Practice Address - Phone:908-755-9797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA066595207R00000X
NJMA66595207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0224138Medicaid