1740513670 NPI number — HANIYYAH SIDDEEQAH HESTER CRNA

Table of content: HANIYYAH SIDDEEQAH HESTER CRNA (NPI 1740513670)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740513670 NPI number — HANIYYAH SIDDEEQAH HESTER CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HESTER
Provider First Name:
HANIYYAH
Provider Middle Name:
SIDDEEQAH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

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:
1740513670
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/21/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
185 SOUTH ORANGE AVENUE MSB C594
Provider Second Line Business Mailing Address:
UNIVERSITY OF MEDICINE & DENTISTRY
Provider Business Mailing Address City Name:
NEWARK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07101
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-972-1634
Provider Business Mailing Address Fax Number:
973-972-3244

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 CLARA MAASS DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLEVILLE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07109-3550
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-450-2000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/10/2009

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: 163W00000X , with the licence number:  NJ26NO12404500 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2100X , with the licence number: 26NJ00086300 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367500000X , with the licence number: 26NJ00086300 , 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)





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