Healthcare Provider Details

I. General information

NPI: 1306373436
Provider Name (Legal Business Name): HMP MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 STATE RT 440 STE 33
JERSEY CITY NJ
07304-1069
US

IV. Provider business mailing address

701 STATE RT 440 STE 33
JERSEY CITY NJ
07304-1069
US

V. Phone/Fax

Practice location:
  • Phone: 201-435-4558
  • Fax: 201-435-4588
Mailing address:
  • Phone: 201-435-4558
  • Fax: 201-435-4588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MA06102900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25MA06102900
License Number StateNJ

VIII. Authorized Official

Name: DR. JOANN SHAKARJIAN
Title or Position: MEMBER/MANAGER
Credential: MD
Phone: 201-435-4558