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General NPI Number Information
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NPI Number | 1427636075
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Entity Type | Individual
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Provider Name | JUSTIN HAM DO
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Gender | Male
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Dates
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Enumeration Date | 04/01/2021
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 176 PALISADE AVE
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City | JERSEY CITY
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State | NJ
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Zip | 07306-1196
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Country | US
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Telephone | 201-795-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 333 BORTHWICK AVE STE 100
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City | PORTSMOUTH
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State | NH
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Zip | 03801-4198
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 25MB12768700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207RS0010X
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Taxonomy Name | Sports Medicine (Internal Medicine) Physician
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License Number | 25MB1278700
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License Number State | NJ
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