1760583801 NPI number — DR. HALA M EID MD

Table of content: DR. HALA M EID MD (NPI 1760583801)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760583801 NPI number — DR. HALA M EID MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EID
Provider First Name:
HALA
Provider Middle Name:
M
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:
1760583801
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/12/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 FEDERAL ST
Provider Second Line Business Mailing Address:
STE SW200
Provider Business Mailing Address City Name:
CAMDEN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08103-1155
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-325-6770
Provider Business Mailing Address Fax Number:
856-673-4510

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
900 CENTENNIAL BLVD
Provider Second Line Business Practice Location Address:
BUILDING 2 SUITE 201
Provider Business Practice Location Address City Name:
VOORHEES
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08043-4637
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-325-6770
Provider Business Practice Location Address Fax Number:
856-673-4510
Provider Enumeration Date:
09/25/2006

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: 207RR0500X , with the licence number:  MA064144 , 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: P00206983 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 3700334 . This is a "AETNA US HEALTHCARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P3553428 . This is a "OXFORD HEALTH PLAN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 40345 . This is a "UNIVERSITY HEALTH CARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2134153 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 3K6154 . This is a "HEALTHNET, INC" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 60014003 . This is a "HORIZON NJ HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2140553000 . This is a "AMERIHEALTH HMO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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