Individual
DR. HOMAYOON HATEFI
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
145 PROSPECT ST, RIDGEWOOD, NJ 07450
(201) 445-7776
(201) 445-4209
Mailing address
145 PROSPECT ST, RIDGEWOOD, NJ 07450
(201) 445-7776
(201) 445-4209
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
137050
NY
207RG0100X
Gastroenterology Physician
Primary
9325
DC
207RG0100X
Gastroenterology Physician
MA32611
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4727100
—
NJ
Enumeration date
03/31/2006
Last updated
09/11/2025
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