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General NPI Number Information
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NPI Number | 1841528254
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Entity Type | Organization
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Legal Business Name | HEMOSER II, LLC
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Dates
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Enumeration Date | 11/23/2009
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Last Update Date | 10/31/2012
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Provider Practice Location Address
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Address Line | 147 HAMILTON AVENUE
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City | PASSAIC
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State | NJ
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Zip | 07055-5240
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Country | US
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Telephone | 973-594-0808
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Fax | 973-594-0508
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Provider Business Mailing Address
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Address Line | 1085 FRANKLIN LAKES ROAD
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City | FRANKLIN LAKES
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State | NJ
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Zip | 07417-1131
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Country | US
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Telephone | 973-594-0808
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Fax | 973-594-0508
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Authorized Official
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Title or Position | OWNER
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Name | DR. BENJAMIN ANTONIO SABIDO
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Credential | M.D.
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Telephone | 973-594-0808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 25MA07696900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 25MA07696900
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License Number State | NJ
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