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NPI Code Detail

MEDICARE: DR. MIRA KAMAL KAGA M.D.

MEDICARE: DR. MIRA KAMAL KAGA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician25MA09379200NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1322546RNSOTHERNJPTAN

General Provider Information

NPI Number : 1760707327
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MIRA KAMAL KAGA M.D.
Provider Business Mailing Address
First Line : 58 N MAIN ST
Second Line :
City : MARLBORO
State : NJ
Zip : 07746-1451
Country : US
Telephone Number : 732-719-2001
Fax Number : 732-719-2002
Provider Business Practice Location Address
First Line : 58 N MAIN ST
Second Line :
City : MARLBORO
State : NJ
Zip : 07746-1451
Country : US
Telephone Number : 732-719-2001
Fax Number : 732-719-2002
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2010
Last Update Date : 07/30/2021

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