1013908847 NPI number — NAIM T. NAZHA MD PC

Table of content: (NPI 1013908847)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013908847 NPI number — NAIM T. NAZHA MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NAIM T. NAZHA MD PC
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:
NAZHA CANCER CENTER
Provider Other Organization Name Type Code:
3
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:
1013908847
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
411 NEW RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTHFIELD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08225-1648
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-383-6033
Provider Business Mailing Address Fax Number:
609-383-0064

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
411 NEW RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTHFIELD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08225-1648
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-383-6033
Provider Business Practice Location Address Fax Number:
609-383-0064
Provider Enumeration Date:
11/01/2005

Additional Information

Authorized Official

Authorized Official Last Name:
NAZHA
Authorized Official First Name:
NAIM
Authorized Official Middle Name:
T.
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
609-383-6033

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , with the licence number:  25MA04569800 , 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)

  • Identifier: 000563232 . This is a "AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 001611701 . This is a "AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0527530001 . This is a "MEDICARE DMERC" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: E63232 . This is a "AMERIHEALTH ADMINISTRATOR" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0057805 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 110027221 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: DN2359 . This is a "RAILROAD MEDICARE GROUP PTAN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 84254 . This is a "AMERICAID" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0013749 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 228906200 . This is a "AMERIHEALTH HMO/PPO/POS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 7437560 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0004104162 . This is a "AETNA LIFE INSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1730136854 . This is a "RAILROAD MEDICARE FROUP MEMBER NPI" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P515578 . This is a "OXFORD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 000563232 . This is a "HIGHMARK" identifier . This identifiers is of the category "OTHER".
  • Identifier: Q11701 . This is a "AMERIHEALTH ADMINISTRATOR" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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