Healthcare Provider Details

I. General information

NPI: 1861411134
Provider Name (Legal Business Name): HANY MORRIS GENDY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 03/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 ROUTE 33 SUITE 6
MILLSTONE TOWNSHIP NJ
08535-9427
US

IV. Provider business mailing address

514 ROUTE 33 WEST SUITE 6
MILLSTONE NJ
08535
US

V. Phone/Fax

Practice location:
  • Phone: 732-851-7007
  • Fax: 732-786-0012
Mailing address:
  • Phone: 732-851-7007
  • Fax: 732-786-0012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA07795100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: