Provider Demographics
NPI:1962812768
Name:HEALTHFAIR PLUS NJ PC
Entity Type:Organization
Organization Name:HEALTHFAIR PLUS NJ PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RAY
Authorized Official - Middle Name:
Authorized Official - Last Name:EKBATANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-672-0919
Mailing Address - Street 1:1030 SPRING VILLAS PT STE 3000
Mailing Address - Street 2:STE 319
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-6621
Mailing Address - Country:US
Mailing Address - Phone:407-672-0919
Mailing Address - Fax:
Practice Address - Street 1:233 MOUNT AIRY RD
Practice Address - Street 2:1ST FLOOR
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-2338
Practice Address - Country:US
Practice Address - Phone:407-672-0919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-01
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty