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. NPI 1720222060
Title
Owner
Phone
(732) 422-3398

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
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)CodeLicenseStatePrimary
Infectious Disease Physician
Group: 193400000X SINGLE SPECIALTY GROUP
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

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 11, 2015.

{
    "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": []
}

Other providers in North Brunswick, NJ

All providers in North Brunswick, NJ · Infectious Disease Physician in New Jersey

Sources for this page

Verify at the official NPI Registry.