Healthcare Provider Details

I. General information

NPI: 1881011237
Provider Name (Legal Business Name): HANY ABDALLAH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2014
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 ELM ST APT 3
MADISON NJ
07940-1553
US

IV. Provider business mailing address

27 ELM ST APT 3
MADISON NJ
07940-1553
US

V. Phone/Fax

Practice location:
  • Phone: 973-443-0052
  • Fax:
Mailing address:
  • Phone: 973-443-0052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number25MA10920800
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number304573
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: