Provider Demographics
NPI:1417963505
Name:MOJARES, RICHARD A (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:MOJARES
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 1:1910 ROUTE 35 SOUTH
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-2715
Mailing Address - Country:US
Mailing Address - Phone:732-531-0100
Mailing Address - Fax:732-531-0144
Practice Address - Street 1:1910 ROUTE 35 SOUTH
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-2715
Practice Address - Country:US
Practice Address - Phone:732-531-0100
Practice Address - Fax:732-531-0144
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA72134207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
222356548OtherBEECHSTREET CORPORATION
222356548OtherHEALTHNETWORK AMERICA
P3385957OtherOXFORD
222356548OtherGEHA
222356548OtherNEW JERSEY CARPENTERS FUN
222356548OtherQUALCARE
2K3697OtherHEALTHNET
7070451OtherAETNA
2105210OtherCIGNA
222356548OtherOPERATING ENGINEERS LOCAL
222356548OtherPHCS
2235553OtherUNITED HEALTHCARE
NJ9008900Medicaid
3310293OtherAETNA
222356548OtherFIRST MANAGED CARE OPTION
222356548OtherCHN
222356548OtherST BARNABAS SYSTEM HEALTH
K6311OtherHORIZON BLUE CROSS BLUE S
222356548OtherNEW JERSEY CARPENTERS FUN
063200RM9Medicare ID - Type Unspecified