Healthcare Provider Details

I. General information

NPI: 1922347772
Provider Name (Legal Business Name): HEMATOLOGY ONCOLOGY AFFILIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2013
Last Update Date: 02/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 CHELSEA DR
LIVINGSTON NJ
07039-3424
US

IV. Provider business mailing address

9 CHELSEA DR
LIVINGSTON NJ
07039-3424
US

V. Phone/Fax

Practice location:
  • Phone: 201-858-1211
  • Fax:
Mailing address:
  • Phone: 201-858-1211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: REKHA D IYENGAR
Title or Position: SOLE MBR
Credential:
Phone: 201-858-1211