| Organization Name: | KESPRA MEDICAL CENTER LLC |
| NPI Number: | 1043517857 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PULIN H PATEL (PRESIDENT OF KESPRA) |
| Mailing Address: | 57 Oliver Ave Edison |
| State: | NJ US |
| Postal Code: | 088203144 |
| Phone Number: | 7326359316 |
| Fax Number: | 7326359136 |
| NPI Enumeration Date: | 02/15/2011 |
| NPI Last Update Date: | 02/15/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 302R00000X |
| License Number: | 25MA08345000 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Managed Care Organizations |
| Taxonomy Classification: | Health Maintenance Organization |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |