1346261179 NPI number — HEMATOLOGY ONCOLOGY ASSOCIATES, SJ, PA

Table of content: (NPI 1346261179)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346261179 NPI number — HEMATOLOGY ONCOLOGY ASSOCIATES, SJ, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEMATOLOGY ONCOLOGY ASSOCIATES, SJ, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346261179
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/21/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
175 MADISON AVENUE
Provider Second Line Business Mailing Address:
4TH FLOOR STOKES BUILDING
Provider Business Mailing Address City Name:
MT. HOLLY
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08060
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-702-1900
Provider Business Mailing Address Fax Number:
609-702-8455

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
175 MADISON AVE
Provider Second Line Business Practice Location Address:
4TH FLOOR STOKES BLDG
Provider Business Practice Location Address City Name:
MT HOLLY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08060
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-702-1900
Provider Business Practice Location Address Fax Number:
609-702-8455
Provider Enumeration Date:
07/21/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LOSSE
Authorized Official First Name:
JOANNE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE ADMINISTRATOR
Authorized Official Telephone Number:
609-702-1900

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4527003 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: CI0289 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: J014918 . This is a "CHAMPUS" identifier . This identifiers is of the category "OTHER".