Provider Demographics
NPI:1871789628
Name:C. E. PASUPATHY
Entity type:Organization
Organization Name:C. E. PASUPATHY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GANDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-451-9395
Mailing Address - Street 1:2950 COLLEGE DR
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-6933
Mailing Address - Country:US
Mailing Address - Phone:856-691-7588
Mailing Address - Fax:856-691-0433
Practice Address - Street 1:2950 COLLEGE DR
Practice Address - Street 2:SUITE 1B
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-6933
Practice Address - Country:US
Practice Address - Phone:856-691-7588
Practice Address - Fax:856-691-0433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-14
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03258300174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty