Individual
DR. HANNA GEBRE MEDHIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10A W RAILROAD AVE, JAMESBURG, NJ 08831-6783
(732) 561-7810
(732) 631-0742
Mailing address
13 SUMMERFIELD DR, MONROE, NJ 08831-3275
(732) 561-7810
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
25MA07639600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0148695
—
NJ
01
—
1780866129
GROUP NPI IN WHICH MEDICAID IS REGISTERED UNDER
NJ
Enumeration date
10/26/2007
Last updated
10/04/2013
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