1487864021 NPI number — CAREPOINT GASTROENTEROLOGY CENTER PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487864021 NPI number — CAREPOINT GASTROENTEROLOGY CENTER PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAREPOINT GASTROENTEROLOGY CENTER 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:
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:
1487864021
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/27/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 7996
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HALEDON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07538-7996
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-595-6444
Provider Business Mailing Address Fax Number:
973-782-4819

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1300 MAIN AVE
Provider Second Line Business Practice Location Address:
SUITE 1B
Provider Business Practice Location Address City Name:
CLIFTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07011-2266
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-689-6700
Provider Business Practice Location Address Fax Number:
973-689-6582
Provider Enumeration Date:
05/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HAJJAR
Authorized Official First Name:
BASSAM
Authorized Official Middle Name:
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
973-595-6444

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  25MA07031400 , 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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