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General NPI Number Information
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NPI Number | 1811394240
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Entity Type | Organization
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Legal Business Name | HACKETTSTOWN PEDIATRICS HOSPITALISTS, LLC
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Dates
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Enumeration Date | 12/01/2014
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Last Update Date | 12/01/2014
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Provider Practice Location Address
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Address Line | 290 UNION BLVD
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City | TOTOWA
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State | NJ
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Zip | 07512-2610
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Country | US
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Telephone | 973-928-3342
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 116
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City | TOTOWA
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State | NJ
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Zip | 07511-0116
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Country | US
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Telephone | 973-928-3342
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Fax |
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Authorized Official
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Title or Position | INCORPORATOR
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Name | DR. YOUSEF ABDULMISAH
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Credential | MD
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Telephone | 973-928-3342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 25MA06251200
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License Number State | NJ
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