MEDICARE: DR. REYAD MOHSEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	MA62887	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689635286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REYAD MOHSEN MD

Provider Business Mailing Address
First Line	:	PO BOX 4630
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07474-4630
Country	:	US
Telephone Number	:	973-790-3433
Fax Number	:	973-790-0433

Provider Business Practice Location Address
First Line	:	508 HAMBURG TPKE
Second Line	:	SUITE 202
City	:	WAYNE
State	:	NJ
Zip	:	07470-8482
Country	:	US
Telephone Number	:	973-790-3433
Fax Number	:	973-790-0433

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	01/24/2008

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