Healthcare Provider Details

I. General information

NPI: 1992720999
Provider Name (Legal Business Name): IRWIN HAMETZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 01/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 SCHANCK RD SUITE B-3
FREEHOLD NJ
07728-2964
US

IV. Provider business mailing address

77-55 SCHANCK RD, STE B3 SUITE B3
FREEHOLD NJ
07728-2942
US

V. Phone/Fax

Practice location:
  • Phone: 732-462-9800
  • Fax: 732-308-1647
Mailing address:
  • Phone: 732-462-9800
  • Fax: 732-462-9800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMA34616
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: