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General NPI Number Information
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NPI Number | 1235140203
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Entity Type | Organization
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Legal Business Name | VETERAN HOSPITAL
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 151 KNOLLCROFT RD
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City | LYONS
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State | NJ
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Zip | 07939-5001
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Country | US
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Telephone | 908-647-0180
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Fax |
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Provider Business Mailing Address
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Address Line | 136 MAIN ST
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City | WEST ORANGE
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State | NJ
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Zip | 07052-5605
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Country | US
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Telephone | 973-736-3625
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Fax |
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Authorized Official
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Title or Position | ATTENDING, PSYCHIATRIST
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Name | FARIDA IQBAL-HUSSAIN
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Credential | MD
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Telephone | 908-647-0180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 25MA07977700
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License Number State | NJ
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