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MAIN STREET MEDICAL PROVIDERS LLC NPI 1790497444


NPI Information

NPI: 1790497444
Provider Name: MAIN STREET MEDICAL PROVIDERS LLC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
65 LEAH WAY
PARSIPPANY, NJ
ZIP 07054
Phone: (551) 223-7912
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MAIN STREET MEDICAL PROVIDERS LLC is an internal medicine in Parsippany, NJ. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. MAIN STREET MEDICAL PROVIDERS LLC NPI is 1790497444. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

65 LEAH WAY
PARSIPPANY, NJ
ZIP 07054-448
Phone: (551) 223-7912
Fax: (646) 701-5598

The provider's authorized official is Santhosh Chakilam .
The authorized official title is Owner and has the following contact phone number (551) 223-7912.

The enumeration date for this NPI number is 12/14/2022 and was last updated on 12/14/2022.


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
1207R00000XInternal MedicineYes

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
125MA09915600OTHERNEW JERSEYLICENSE

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

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