VIVIAN K. BETHALA MD PA NPI 1568412799

NPI Information

NPI: 1568412799
Provider Name: VIVIAN K. BETHALA, MD PA
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
466 OLD HOOK RD
SUITE 9
EMERSON, NJ
ZIP 07630
Phone: (201) 261-1005
Get Directions

VIVIAN K. BETHALA, MD PA is a specialist in Emerson, NJ. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. VIVIAN K. BETHALA, MD PA NPI is 1568412799. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

466 OLD HOOK RD
SUITE 9
EMERSON, NJ
ZIP 07630-396
Phone: (201) 261-1005
Fax: (201) 261-4208

The provider's authorized official is Vivian K Bethala .
The authorized official title is President and has the following contact phone number (201) 261-1005.

The enumeration date for this NPI number is 5/10/2006 and was last updated on 12/2/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		25MA0371400	NEW JERSEY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	C56423	MEDICARE UPIN	NEW JERSEY
2	025511	MEDICARE ID-TYPE UNSPECIFIED	NEW JERSEY	MEDICARE PROVIDER NUMBER
3	4906403	MEDICAID	NEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »