Healthcare Provider Details
I. General information
NPI: 1396451787
Provider Name (Legal Business Name): A.-HAHNE ATTIA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/27/2023
Last Update Date: 01/27/2023
Certification Date: 01/27/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14 CLIFFWOOD AVE
MATAWAN NJ
07747-3908
US
IV. Provider business mailing address
305 RUSTIC DR
MORGANVILLE NJ
07751-4447
US
V. Phone/Fax
- Phone: 516-965-5376
- Fax:
- Phone: 516-965-5376
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QX0100X |
| Taxonomy | Occupational Medicine Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ABEER
ALOUSH
Title or Position: CEO
Credential: PHD
Phone: 516-965-5376