Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | MA60489 | NJ |
NPI | 1134229172 |
---|---|
Provider Name | Dr. Jagbir S Beniwal |
First Address | Wayne, NJ 07470 |
Second Address | Wayne, NJ 07470 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 27/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0103538 | (02) | |
0103538 | GHI (01) | |
1125433 | NJ HEALTH (01) | |
3063025 | AETNA (01) | |
6970508 | (05) | NJ |
6970508 | AMERIGROUP (01) | |
91000121202 | AMERICHOICE (01) | |
H910001212 | AMERIHEALTH (01) | |
J35036 | HEALTHNET (01) | |
P00009802 | PALMETTO RR MEDICARE (01) | |
P430830 | OXFORD (01) |