Provider Demographics
NPI:1124124649
Name:JAIN, AMI JATINKUMAR (MD)
Entity type:Individual
Prefix:
First Name:AMI
Middle Name:JATINKUMAR
Last Name:JAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 WHITE MEADOW ROAD
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844
Mailing Address - Country:US
Mailing Address - Phone:908-281-9323
Mailing Address - Fax:
Practice Address - Street 1:720 US HWY 202 206 N
Practice Address - Street 2:PEDIAHEALTH MEDICAL ASSOCIATES
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807
Practice Address - Country:US
Practice Address - Phone:908-722-5444
Practice Address - Fax:908-722-5071
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA69522208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics