Provider Demographics
NPI:1205873676
Name:CAPITAL HEALTH SYSTEM
Entity type:Organization
Organization Name:CAPITAL HEALTH SYSTEM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ADITY
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATTACHRYYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-815-2677
Mailing Address - Street 1:P.O. BOX 8500-1601
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:433 BELLEVUE AVE
Practice Address - Street 2:4TH FLOOR
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-4514
Practice Address - Country:US
Practice Address - Phone:609-815-2677
Practice Address - Fax:609-815-2682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6779603Medicaid
NJ048251PVKMedicare PIN