Healthcare Provider Details

I. General information

NPI: 1841438447
Provider Name (Legal Business Name): FERYAL HAJEE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2009
Last Update Date: 02/28/2020
Certification Date: 02/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 SYCAMORE AVE STE 1A
LITTLE SILVER NJ
07739-1228
US

IV. Provider business mailing address

617 79TH ST
NORTH BERGEN NJ
07047-4930
US

V. Phone/Fax

Practice location:
  • Phone: 732-383-5554
  • Fax: 732-383-5495
Mailing address:
  • Phone: 201-854-8119
  • Fax: 201-854-4875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberMA08471500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: