Healthcare Provider Details

I. General information

NPI: 1760583801
Provider Name (Legal Business Name): HALA M EID MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 01/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 CENTENNIAL BLVD BUILDING 2 SUITE 201
VOORHEES NJ
08043-4637
US

IV. Provider business mailing address

1 FEDERAL ST STE SW200
CAMDEN NJ
08103-1155
US

V. Phone/Fax

Practice location:
  • Phone: 856-325-6770
  • Fax: 856-673-4510
Mailing address:
  • Phone: 856-325-6770
  • Fax: 856-673-4510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMA064144
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: