Provider Demographics
NPI:1598841975
Name:NIGAM, AVINASH C (MD)
Entity type:Individual
Prefix:DR
First Name:AVINASH
Middle Name:C
Last Name:NIGAM
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 1:319 W JERSEY ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07202-1805
Mailing Address - Country:US
Mailing Address - Phone:908-355-5454
Mailing Address - Fax:908-355-5483
Practice Address - Street 1:319 W JERSEY ST
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-1805
Practice Address - Country:US
Practice Address - Phone:908-355-5454
Practice Address - Fax:908-355-5483
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03030400207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ009071OtherONE HEALTH
NJ8816816Medicaid
NJ534019OtherAETNA US HEALTHCARE
NJ57224100OtherEMPIRE-NY
NJF06261OtherPHS
NJ204020OtherLPH
NJ1044179OtherHORIZON MERCY-NJ
NJ572242OtherHORIZON BC & BS OF NJ
NJINL000036OtherAMERICHOICE
NJ3856513008OtherCIGNA
NJNI509857Medicare ID - Type UnspecifiedMEDICARE IDENTIFICATION #
NJ572242OtherHORIZON BC & BS OF NJ