Provider Demographics
NPI:1447255898
Name:KATDARE, UMESH (MD)
Entity type:Individual
Prefix:DR
First Name:UMESH
Middle Name:
Last Name:KATDARE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2566
Mailing Address - Street 2:
Mailing Address - City:GUTTENBERG
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-0641
Mailing Address - Country:US
Mailing Address - Phone:201-854-0055
Mailing Address - Fax:201-854-2633
Practice Address - Street 1:425 70TH ST
Practice Address - Street 2:
Practice Address - City:GUTTENBERG
Practice Address - State:NJ
Practice Address - Zip Code:07093-2417
Practice Address - Country:US
Practice Address - Phone:201-854-0055
Practice Address - Fax:201-854-2633
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA071684207RI0011X
NJ25MA07168400207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3614421OtherAETNA HMO #
NJP00174451OtherRAILROAD MDCR #
NJ2K8700OtherHEALTHNET #
NJ612Q12OtherEMPIRE BC/BS NEWARK #
NJ8221517OtherGHI ID #
NJP3389564OtherOXFORD #
NJ0036331OtherMEDICAID ID #
NJ01000676400OtherAMERICHOICE ID #
NJ612Q13OtherEMPIRE BC/BS SECAUCUS #
NJ40570OtherUNIVERSITY HEALTH PLANS #
NJ612Q11OtherEMPIRE BC/BS GUTTENBERG #
NJ0036331Medicaid
NJ2394424000OtherAMERIHEALTH ID #
NJ7307613OtherAETNA PPO #
NJ612Q11OtherEMPIRE BC/BS GUTTENBERG #
NJ0036331Medicaid