Provider Demographics
NPI:1740395433
Name:UMALI, WINSTON CARAOS (MD)
Entity Type:Individual
Prefix:
First Name:WINSTON
Middle Name:CARAOS
Last Name:UMALI
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:PO BOX 24203
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304
Mailing Address - Country:US
Mailing Address - Phone:201-209-9007
Mailing Address - Fax:201-432-5142
Practice Address - Street 1:395 DANFORTH AVE
Practice Address - Street 2:DANFORTH PLAZA
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305
Practice Address - Country:US
Practice Address - Phone:201-209-9007
Practice Address - Fax:201-432-5142
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA69637208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
01000200800OtherAMERICHOICE
2007412OtherUNITED HEALTHCARE
1K6028OtherPHYSICIAN HEALTH SERVICE
24094OtherUNIVERSITY HEALTH PLANS
2C6641OtherEMPIRE
NJ8004803Medicaid
2016130000OtherAMERIHEALTH PPO HMO
6932665003OtherCIGNA
2427932OtherAETNA
59532OtherAMERICAID
8004803OtherUNISYS MEDICAID
1111481OtherHORIZON NJ HEALTH
2698488OtherGHI
P2117215OtherOXFORD
1K6028OtherACS HEALTHNET
9345461OtherONE HEALTH PLAN
2442532OtherAETNA
59532OtherAMERIGROUP
K0846OtherHORIZON BCBS