Organization
NJ DIAGNOSTIC TESTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAMMAL HASSANIEN DO (SOLE MBR)
(973) 523-4000
Entity
Organization
Contact information
Practice address
606 BROADWAY, PATERSON, NJ 07514-1916
(973) 523-4000
Mailing address
606 BROADWAY, PATERSON, NJ 07514-1916
(973) 523-4000
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2085R0202X
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00423400
RAIL ROAD MEDICARE
NJ
Enumeration date
07/10/2013
Last updated
07/10/2013
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