Provider Demographics
NPI:1760591390
Name:DOSHI MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:DOSHI MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PANKAJ
Authorized Official - Middle Name:AJAY
Authorized Official - Last Name:DOSHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-588-0648
Mailing Address - Street 1:PO BOX 757
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-0757
Mailing Address - Country:US
Mailing Address - Phone:732-588-0648
Mailing Address - Fax:732-960-2378
Practice Address - Street 1:670 N BEERS ST
Practice Address - Street 2:BLDG 2, SUITE 4
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1526
Practice Address - Country:US
Practice Address - Phone:732-588-0648
Practice Address - Fax:732-960-2378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07621800207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0124907Medicaid
NJ102813VLMMedicare PIN