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NPI Code Detail

MEDICARE: HAZEL HEALTH SERVICES NORTHEAST PC

MEDICARE: HAZEL HEALTH SERVICES NORTHEAST PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician
2363A00000XPhysician Assistant
3363AM0700XMedical Physician Assistant
4363L00000XNurse Practitioner
5208000000XPediatrics Physician

General Provider Information

NPI Number : 1013776715
Entity Type Code : Organization
Provider Name (Legal Business Name) : HAZEL HEALTH SERVICES NORTHEAST PC
Provider Business Mailing Address
First Line : 8300 ESTERS BLVD STE 900
Second Line :
City : IRVING
State : TX
Zip : 75063-2233
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1400 HOOPER AVE STE 2
Second Line :
City : TOMS RIVER
State : NJ
Zip : 08753-2981
Country : US
Telephone Number : 415-424-4266
Fax Number : 415-520-6633
Authorized Official
Title or Position : PRESIDENT
Name : BRIJIT REIS
Credential : MD
Telephone Number : 415-424-4266
Provider Enumeration Date : 03/15/2024
Last Update Date : 06/02/2025

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Directions to “HAZEL HEALTH SERVICES NORTHEAST PC ” Practice Location

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