Healthcare Provider Details

I. General information

NPI: 1235260704
Provider Name (Legal Business Name): WAYNE HEMATOLOGY ONCOLOGY ASSOCIATES P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 11/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

468 PARISH DR STE 4
WAYNE NJ
07470-4671
US

IV. Provider business mailing address

468 PARISH DR STE 4
WAYNE NJ
07470-4671
US

V. Phone/Fax

Practice location:
  • Phone: 973-694-5005
  • Fax: 973-694-5990
Mailing address:
  • Phone: 973-694-5005
  • Fax: 973-694-5990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: VIJAY ROY
Title or Position: VICE PRESIDENT
Credential: M.D.
Phone: 973-694-5005