Provider Demographics
NPI:1811278047
Name:ARK INTERNAL MEDICINE LLC
Entity type:Organization
Organization Name:ARK INTERNAL MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KHADIJA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-371-4584
Mailing Address - Street 1:26 RICHARD RD
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08852-2522
Mailing Address - Country:US
Mailing Address - Phone:732-371-4584
Mailing Address - Fax:732-388-3328
Practice Address - Street 1:26 RICHARD RD
Practice Address - Street 2:
Practice Address - City:MONMOUTH JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08852-2522
Practice Address - Country:US
Practice Address - Phone:732-371-4584
Practice Address - Fax:732-388-3328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-01
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07599600313M00000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0015733Medicaid
NJ075788Medicare Oscar/Certification
NJH99072Medicare UPIN