Provider Demographics
NPI:1982678983
Name:NAG, DEBASHIS (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBASHIS
Middle Name:
Last Name:NAG
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 1:9 HOSPITAL DR
Mailing Address - Street 2:SUITE C-25
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-6425
Mailing Address - Country:US
Mailing Address - Phone:732-736-0100
Mailing Address - Fax:
Practice Address - Street 1:9 HOSPITAL DR
Practice Address - Street 2:SUITE C-25
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6425
Practice Address - Country:US
Practice Address - Phone:732-736-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA65594208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8371008Medicaid
NJ250012835OtherRAIL ROAD MEDICARE
NJ8371008Medicaid
NJ43646DJ2Medicare PIN