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NPI Code Detail

MEDICARE: BASSAM M HADDAD, MD, PA

MEDICARE: BASSAM M HADDAD, MD, PA
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
1174400000XSpecialist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821205063
Entity Type Code : Organization
Provider Name (Legal Business Name) : BASSAM M HADDAD, MD, PA
Provider Business Mailing Address
First Line : 26 GREENVILLE AVE
Second Line :
City : JERSEY CITY
State : NJ
Zip : 07305-2608
Country : US
Telephone Number : 201-333-8222
Fax Number :
Provider Business Practice Location Address
First Line : 26 GREENVILLE AVE
Second Line :
City : JERSEY CITY
State : NJ
Zip : 07305-2608
Country : US
Telephone Number : 201-333-8222
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : BASSAM M HADDAD
Credential : M.D
Telephone Number : 201-333-8222
Provider Enumeration Date : 05/17/2007
Last Update Date : 12/19/2016

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Directions to “BASSAM M HADDAD, MD, PA ” Practice Location

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