1255338216 NPI number — ONCOLOGY AND HEMATOLOGY ASSOCIATES

Table of content: (NPI 1255338216)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255338216 NPI number — ONCOLOGY AND HEMATOLOGY ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ONCOLOGY AND HEMATOLOGY ASSOCIATES
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:
1255338216
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1029 N BROAD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WOODBURY
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08096-3503
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-848-5132
Provider Business Mailing Address Fax Number:
856-384-0275

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17 W RED BANK AVE
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
WOODBURY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08096-1630
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-848-9292
Provider Business Practice Location Address Fax Number:
856-384-0275
Provider Enumeration Date:
07/06/2005

Additional Information

Authorized Official

Authorized Official Last Name:
STAMBAUGH
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
E
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
856-848-9292

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , 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: 007331 . This is a "PENNSYLVANIA BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 007331 . This is a "BLAIRMILL" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0191516000 . This is a "KEYSTONE EAST" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1027469 . This is a "HORIZON NJ MERCY HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0191516000 . This is a "AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 8427668 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: A7797 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: G395759 . This is a "OXFORD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 01000343100 . This is a "AMERICHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2500265 . This is a "GHI" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2750201 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0007374 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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