Healthcare Provider Details

I. General information

NPI: 1417143678
Provider Name (Legal Business Name): SOHAIL G HADDAD M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2007
Last Update Date: 11/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 STATE ROUTE 31 STE 300
FLEMINGTON NJ
08822-5744
US

IV. Provider business mailing address

121 STATE ROUTE 31 STE 300
FLEMINGTON NJ
08822-5744
US

V. Phone/Fax

Practice location:
  • Phone: 908-788-6474
  • Fax: 908-788-6616
Mailing address:
  • Phone: 908-788-6474
  • Fax: 908-788-6616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number25MA07934200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: