1023142676 NPI number — DR. SABEENA FARHATH MD

Table of content: DR. SABEENA FARHATH MD (NPI 1023142676)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023142676 NPI number — DR. SABEENA FARHATH MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FARHATH
Provider First Name:
SABEENA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1023142676
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/26/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2123 KLOCKNER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAMILTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08690-3417
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-586-7337
Provider Business Mailing Address Fax Number:
609-586-7338

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1401 WHITEHORSE MERCERVILLE RD STE 215
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAMILTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08619-3835
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-528-8894
Provider Business Practice Location Address Fax Number:
609-528-8896
Provider Enumeration Date:
03/15/2007

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: 2080P0206X , with the licence number:  C7-0002883 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2080P0206X , with the licence number: MA08176100 , 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: 5334502 . This is a "CIGNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P3944299 . This is a "OXFORD HEALTH PLAN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 3K8803 . This is a "HEALTHNET, INC" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1922746/9150193 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 60043859 . This is a "HORIZON NJ HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 3542028000 . This is a "AMERIHEALTH/KESYTONE/IBC" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0176711 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: AMERICHOICE . This is a "010046660" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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