MEDICARE: HOBOKEN MEDICAL GROUP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207Q00000X	Family Medicine Physician
2	207V00000X	Obstetrics & Gynecology Physician
3	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1811231327
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOBOKEN MEDICAL GROUP

Provider Business Mailing Address
First Line	:	609 WASHINGTON ST
Second Line	:
City	:	HOBOKEN
State	:	NJ
Zip	:	07030-4907
Country	:	US
Telephone Number	:	120-170-6849
Fax Number	:	201-706-8491

Provider Business Practice Location Address
First Line	:	609 WASHINGTON ST
Second Line	:
City	:	HOBOKEN
State	:	NJ
Zip	:	07030-4907
Country	:	US
Telephone Number	:	120-170-6849
Fax Number	:	201-706-8491

Authorized Official
Title or Position	:	CO-OWNER
Name	:	AZZAM BAKER
Credential	:	MD
Telephone Number	:	201-706-8490

Provider Enumeration Date	:	11/21/2012
Last Update Date	:	11/21/2012

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Directions to “HOBOKEN MEDICAL GROUP ” Practice Location

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