Provider Demographics
NPI:1033387097
Name:MAROULES HEMATOLOGY - ONCOLOGY LLC
Entity Type:Organization
Organization Name:MAROULES HEMATOLOGY - ONCOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MAROULES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:862-591-2002
Mailing Address - Street 1:1011 CLIFTON AVE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-3518
Mailing Address - Country:US
Mailing Address - Phone:862-591-2002
Mailing Address - Fax:862-591-2344
Practice Address - Street 1:1011 CLIFTON AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3518
Practice Address - Country:US
Practice Address - Phone:862-591-2002
Practice Address - Fax:862-591-2344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA038702207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5450900Medicaid
NJ1134221062OtherNPI
NJ1134221062OtherNPI
123591Medicare PIN