Healthcare Provider Details

I. General information

NPI: 1093390627
Provider Name (Legal Business Name): HIND EL-HAMMALI DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2021
Last Update Date: 03/15/2021
Certification Date: 03/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 BERGEN ST STE 7700
NEWARK NJ
07103-2425
US

IV. Provider business mailing address

110 BERGEN ST # D881-04
NEWARK NJ
07103-2495
US

V. Phone/Fax

Practice location:
  • Phone: 973-972-2444
  • Fax:
Mailing address:
  • Phone: 973-972-4615
  • Fax: 973-972-0370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number22DI02814600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: