Provider Demographics
NPI:1679634307
Name:IDEALMED
Entity Type:Organization
Organization Name:IDEALMED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:NEERAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-741-5600
Mailing Address - Street 1:200 WHITE RD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:LITTLE SILVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07739-1150
Mailing Address - Country:US
Mailing Address - Phone:732-741-5600
Mailing Address - Fax:732-345-1001
Practice Address - Street 1:200 WHITE RD
Practice Address - Street 2:SUITE 212
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739-1150
Practice Address - Country:US
Practice Address - Phone:732-741-5600
Practice Address - Fax:732-345-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty