Provider Demographics
NPI:1205858149
Name:HEMANT PAINTER MD PA
Entity type:Organization
Organization Name:HEMANT PAINTER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HEMANT
Authorized Official - Middle Name:
Authorized Official - Last Name:PAINTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-494-0060
Mailing Address - Street 1:1907 OAK TREE RD
Mailing Address - Street 2:SUITE 101A
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2070
Mailing Address - Country:US
Mailing Address - Phone:732-494-0060
Mailing Address - Fax:732-494-6006
Practice Address - Street 1:1907 OAK TREE RD
Practice Address - Street 2:SUITE 101A
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2070
Practice Address - Country:US
Practice Address - Phone:732-494-0060
Practice Address - Fax:732-494-6006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06926300207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ117452Medicare PIN
FLQ0332Medicare PIN