1578709259 NPI number — HOWELL MEDICAL CARE, PA

Table of content: (NPI 1578709259)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578709259 NPI number — HOWELL MEDICAL CARE, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOWELL MEDICAL CARE, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DR OSAMA GHANEM MD PC
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578709259
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/23/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 912
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DAYTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08810-0912
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8 SCENIC WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONROE TOWNSHIP
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08831-5815
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-414-9825
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/30/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GHANEM
Authorized Official First Name:
OSAMA
Authorized Official Middle Name:
K
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
732-646-0198

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)