Healthcare Provider Details

I. General information

NPI: 1285784181
Provider Name (Legal Business Name): HOBOKEN ALLERGY & ASTHMA SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

79 HUDSON ST SUITE 302A
HOBOKEN NJ
07030-5638
US

IV. Provider business mailing address

79 HUDSON ST SUITE 302A
HOBOKEN NJ
07030-5638
US

V. Phone/Fax

Practice location:
  • Phone: 201-792-1109
  • Fax: 201-792-1145
Mailing address:
  • Phone: 201-792-1109
  • Fax: 201-792-1145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number25MA07843300
License Number StateNJ

VIII. Authorized Official

Name: MUNIRIH N TAHZIB
Title or Position: OWNER
Credential: MD
Phone: 201-792-1109