Healthcare Provider Details

I. General information

NPI: 1619102878
Provider Name (Legal Business Name): SAMIT HIRAWAT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2009
Last Update Date: 05/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 BUXTON RD
CHATHAM NJ
07928-1225
US

IV. Provider business mailing address

5 BUXTON RD
CHATHAM NJ
07928-1225
US

V. Phone/Fax

Practice location:
  • Phone: 973-701-0808
  • Fax:
Mailing address:
  • Phone: 973-701-0808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number25MA07813100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: