1578711743 NPI number — DR. TAMIM HANI NABER MD

Table of content: MR. RICHARD ALLEN HANSON II MSW/LSW (NPI 1871891093)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578711743 NPI number — DR. TAMIM HANI NABER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NABER
Provider First Name:
TAMIM
Provider Middle Name:
HANI
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1578711743
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/15/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6725 VENTNOR AVE
Provider Second Line Business Mailing Address:
SUITE C
Provider Business Mailing Address City Name:
VENTNOR CITY
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08406-2166
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-350-6780
Provider Business Mailing Address Fax Number:
609-350-6995

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6725 VENTNOR AVE
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
VENTNOR CITY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08406-2166
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-350-6780
Provider Business Practice Location Address Fax Number:
609-350-6995
Provider Enumeration Date:
08/30/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X , with the licence number:  25MA08426800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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