Healthcare Provider Details

I. General information

NPI: 1295846665
Provider Name (Legal Business Name): HSMG LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

669 VAN HOUTEN AVE
CLIFTON NJ
07013-2125
US

IV. Provider business mailing address

669 VAN HOUTEN AVE
CLIFTON NJ
07013-2125
US

V. Phone/Fax

Practice location:
  • Phone: 973-779-1122
  • Fax: 973-779-8996
Mailing address:
  • Phone: 973-779-1122
  • Fax: 973-779-8996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number28RS00469100
License Number StateNJ

VIII. Authorized Official

Name: MR. OMAR GHARIB
Title or Position: MEMBER
Credential:
Phone: 201-899-6244