Provider Demographics
NPI:1649203498
Name:ALMENDRAS, NOLE E (MD)
Entity Type:Individual
Prefix:DR
First Name:NOLE
Middle Name:E
Last Name:ALMENDRAS
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 1:585 US HIGHWAY ROUTE 72 E
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050
Mailing Address - Country:US
Mailing Address - Phone:609-597-7077
Mailing Address - Fax:609-978-8455
Practice Address - Street 1:585 US HIGHWAY ROUTE 72 E
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050
Practice Address - Country:US
Practice Address - Phone:609-597-7077
Practice Address - Fax:609-978-8455
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04034800208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0744000Medicaid
NJ429898Medicare ID - Type UnspecifiedMEDICARE #
NJ0744000Medicaid