Individual
DR. IMRAN FAYYAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2107 KLOCKNER RD, HAMILTON, NJ 08690-3403
(609) 586-1319
(609) 586-1468
Mailing address
2107 KLOCKNER RD, HAMILTON, NJ 08690-3403
(609) 586-1319
(609) 586-1468
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA06926000
NJ
207RG0100X
Gastroenterology Physician
0101260631
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007528230001
ONE HEALTH PLAN
NJ
01
—
103482
AMERICAID
NJ
01
—
1465716
AMERIHEALTH PPO
NJ
01
—
163917
CHN
NJ
01
—
2124512
FIRST HEALTH
NJ
01
—
2150009000
AMERIHEALTH HMO
NJ
01
—
222233588
HORIZON BC/BS
NJ
01
—
2401109
GHI
NJ
01
—
2959308
AETNA HMO
NJ
01
—
2K2723
HEALTHNET
NJ
01
—
7204313
AETNA PPO
NJ
01
—
88151
LOCAL 825 PPO
NJ
05
—
8856605
—
NJ
01
—
9303718-002
CIGNA
NJ
01
—
P2646425
OXFORD
NJ
Enumeration date
12/06/2005
Last updated
02/17/2022
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