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General NPI Number Information
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NPI Number | 1851319248
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Entity Type | Organization
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Legal Business Name | SATISH K. MITTAL
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 02/05/2014
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Provider Practice Location Address
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Address Line | 2950 COLLEGE DR STE 1C SUITE # 1-C
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City | VINELAND
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State | NJ
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Zip | 08360-6933
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Country | US
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Telephone | 856-691-4800
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Fax | 856-691-4801
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Provider Business Mailing Address
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Address Line | 112 RUNNING DEER TRL
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City | PITTSGROVE
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State | NJ
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Zip | 08318-4186
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Country | US
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Telephone | 856-691-4800
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Fax | 856-691-4801
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. SATISH K MITTAL
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Credential | M.D.
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Telephone | 856-691-4800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 25MA03870400
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License Number State | NJ
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