Organization
MATAWAN ABERDEEN HEART & MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FAZAL R. PANEZAI MD (PHYSICIAN)
(732) 566-6614
Entity
Organization
Contact information
Practice address
177 MAIN ST, MATAWAN, NJ 07747-4107
(732) 566-6614
(732) 290-9448
Mailing address
177 MAIN ST, MATAWAN, NJ 07747-4107
(732) 566-6614
(732) 290-9448
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA33492
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2066602-22
—
NJ
01
—
J1397
HORIZON BLUE CROSS BLUE SHIEL
NJ
Enumeration date
09/04/2009
Last updated
09/04/2009
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