Healthcare Provider Details

I. General information

NPI: 1386462711
Provider Name (Legal Business Name): HEBA ELHAWARY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2024
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1032 RAHWAY AVE
AVENEL NJ
07001-2076
US

IV. Provider business mailing address

1032 RAHWAY AVE
AVENEL NJ
07001-2076
US

V. Phone/Fax

Practice location:
  • Phone: 732-215-7775
  • Fax: 732-215-7776
Mailing address:
  • Phone: 732-215-7775
  • Fax: 732-215-7776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHP0389300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: