Provider Demographics
NPI:1790875961
Name:UGOREC, IGOR (MD)
Entity Type:Individual
Prefix:
First Name:IGOR
Middle Name:
Last Name:UGOREC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:IGORIS
Other - Middle Name:
Other - Last Name:OUGORETS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:310 MADISON AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6967
Mailing Address - Country:US
Mailing Address - Phone:973-285-7800
Mailing Address - Fax:973-285-7805
Practice Address - Street 1:310 MADISON AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6967
Practice Address - Country:US
Practice Address - Phone:973-285-7800
Practice Address - Fax:973-285-7805
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2207172084N0400X, 2084P0005X, 207RC0200X
NJ25MA082994002084N0400X, 2084V0102X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084P0005XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurodevelopmental Disabilities
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0155080Medicaid
NY02227801Medicaid
NY02227801Medicaid
NY365N21Medicare PIN
NYH02844Medicare UPIN