Provider Demographics
NPI:1912062886
Name:HARJINDER S. BEDI MD LLC
Entity Type:Organization
Organization Name:HARJINDER S. BEDI MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARJINDER
Authorized Official - Middle Name:S
Authorized Official - Last Name:BEDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-660-1166
Mailing Address - Street 1:850 W BAY AVE
Mailing Address - Street 2:
Mailing Address - City:BARNEGAT
Mailing Address - State:NJ
Mailing Address - Zip Code:08005-2185
Mailing Address - Country:US
Mailing Address - Phone:609-660-1166
Mailing Address - Fax:609-660-9610
Practice Address - Street 1:850 W BAY AVE
Practice Address - Street 2:
Practice Address - City:BARNEGAT
Practice Address - State:NJ
Practice Address - Zip Code:08005-2185
Practice Address - Country:US
Practice Address - Phone:609-660-1166
Practice Address - Fax:609-660-9610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2815864001OtherAMERIHEALTH
NJ2815864001OtherAMERIHEALTH
458270Medicare PIN
NJI72190Medicare UPIN
NJ110139WD1Medicare PIN
NJC56011Medicare UPIN