Provider Demographics
NPI:1396895595
Name:NAVESINK PRIMARY CARE,INC
Entity type:Organization
Organization Name:NAVESINK PRIMARY CARE,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEEPINDER
Authorized Official - Middle Name:
Authorized Official - Last Name:ARORA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-530-0070
Mailing Address - Street 1:PO BOX 23
Mailing Address - Street 2:
Mailing Address - City:WICKATUNK
Mailing Address - State:NJ
Mailing Address - Zip Code:07765-0023
Mailing Address - Country:US
Mailing Address - Phone:732-530-0070
Mailing Address - Fax:732-530-0043
Practice Address - Street 1:200 WHITE RD
Practice Address - Street 2:SUITE 209
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739-1150
Practice Address - Country:US
Practice Address - Phone:732-530-0070
Practice Address - Fax:732-530-0043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07483400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0004979Medicaid
NJH85186Medicare UPIN
NJ0004979Medicaid