Provider Demographics
NPI:1821144007
Name:ATLANTIC HEALTH CENTER. PC
Entity Type:Organization
Organization Name:ATLANTIC HEALTH CENTER. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PRAHLAD
Authorized Official - Middle Name:MANIBHAI
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-875-5152
Mailing Address - Street 1:600 CROSS KEYS RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-4147
Mailing Address - Country:US
Mailing Address - Phone:856-875-5152
Mailing Address - Fax:856-875-0313
Practice Address - Street 1:2300 ATLANTIC AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401-6680
Practice Address - Country:US
Practice Address - Phone:609-345-9100
Practice Address - Fax:609-345-6114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-28
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ087902Medicare PIN