Amandeep K Pall MD LLC
Organization Active NPI Infectious Disease Physician · North Brunswick, NJ
NPI 1487900585 · NPPES record last updated Feb 11, 2015
Key facts
- NPI
- 1487900585
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Infectious Disease Physician 207RI0200X
- License
- 25MA08862000 (NJ)
- Legal business name
- AMANDEEP K PALL MD LLC
- Practice address
- 2090 Route 27
Suite 101
North Brunswick, NJ 08902 - Phone
- (732) 422-3398
- Fax
- (973) 618-5523
- NPI assigned
- Jul 27, 2012
- Organization subpart
- No
Authorized official
- Name
- Amandeep K Pall, M.D.
- Title
- Owner
- Phone
- (732) 422-3398
Practitioners 1
-
Amandeep K Pall, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120808000702 | NJ | Part B Supplier - Clinic/Group Practice | 6204082191 |
Receives reassigned benefits from 1 practitioner Practice locations: Somerset, NJ |
National Provider Directory
Locations
2 State Route 27
Ste 402
Edison, NJ 08820
Phone (908) 444-0756
2090 Route 27
Ste 101E
North Brunswick, NJ 08902
Phone (732) 422-3398
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician |
207RI0200X | 25MA08862000 | NJ | Yes |
Addresses
Primary practice location
2090 Route 27
Suite 101
North Brunswick, NJ 08902
Mailing address
PO Box 6774
Hillsborough, NJ 08844-6774
Phone (732) 422-3398
NPI Registry JSON
{
"created_epoch": "1343347200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1423612800000",
"number": "1487900585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6774",
"city": "HILLSBOROUGH",
"state": "NJ",
"postal_code": "088446774",
"telephone_number": "732-422-3398",
"fax_number": "973-618-5523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2090 ROUTE 27",
"address_2": "SUITE 101",
"city": "NORTH BRUNSWICK",
"state": "NJ",
"postal_code": "08902",
"telephone_number": "732-422-3398",
"fax_number": "973-618-5523"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AMANDEEP K PALL MD LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-07-27",
"last_updated": "2015-02-11",
"status": "A",
"authorized_official_last_name": "PALL",
"authorized_official_first_name": "AMANDEEP",
"authorized_official_middle_name": "K",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "732-422-3398",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Infectious Disease",
"state": "NJ",
"license": "25MA08862000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.