Provider Demographics
NPI:1295758258
Name:KALADAS, JEFFREY (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:KALADAS
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 1:141 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH BOUND BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08880-1480
Mailing Address - Country:US
Mailing Address - Phone:732-560-1234
Mailing Address - Fax:732-560-0210
Practice Address - Street 1:141 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTH BOUND BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08880-1480
Practice Address - Country:US
Practice Address - Phone:732-560-1234
Practice Address - Fax:732-560-0210
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA 61660207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE223404923OtherHORIZON BCBS
NJ5364101OtherAETNA
NJ355316OtherPHCS
NJP1830529OtherOXFORD FREEDOM
NJ7049102Medicaid
NJ1548067OtherUNITED HEALTHCARE
NE223404923OtherHORIZON BCBS
NJ1548067OtherUNITED HEALTHCARE
NJG04910Medicare UPIN