Organization
MANOUCHER KATEBIAN, M.D. PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANOUCHER KATEBIAN (MEDICAL DOCTOR)
(201) 342-3800
Entity
Organization
Contact information
Practice address
274 SUMMIT AVE, HACKENSACK, NJ 07601-1432
(201) 342-3800
(201) 343-7320
Mailing address
274 SUMMIT AVE, HACKENSACK, NJ 07601-1432
(201) 342-3800
(201) 343-7320
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MA02875800
NJ
207R00000X
Internal Medicine Physician
Primary
MA02875800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2914204
—
NJ
01
—
442062045
RAILROAD MEDICARE
NJ
01
—
BS735
OXFORD
NJ
01
—
NJ6763
HEALTHNET
NJ
Enumeration date
04/11/2008
Last updated
06/19/2008
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