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General NPI Number Information
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NPI Number | 1487603163
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Entity Type | Organization
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Legal Business Name | JAGTIANI URGENT& PRIMARY CARE, LLC
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 297 S WASHINGTON AVE SUITE # 1
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City | BERGENFIELD
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State | NJ
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Zip | 07621-3789
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Country | US
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Telephone | 201-387-0087
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Fax | 201-387-2232
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Provider Business Mailing Address
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Address Line | 297 S WASHINGTON AVE SUITE # 1
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City | BERGENFIELD
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State | NJ
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Zip | 07621-3789
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Country | US
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Telephone | 201-387-0087
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Fax | 201-387-2232
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Authorized Official
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Title or Position | MEMBER
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Name | DR. RAJA KISHINCHAND JAGTIANI
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Credential | M.D.
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Telephone | 201-387-0087
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State | NJ
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