Provider Demographics
NPI:1073783577
Name:EL-HAJJAR, MOHAMMAD CHAFIC (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:CHAFIC
Last Name:EL-HAJJAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 PARK LN E APT 12
Mailing Address - Street 2:
Mailing Address - City:MENANDS
Mailing Address - State:NY
Mailing Address - Zip Code:12204-1959
Mailing Address - Country:US
Mailing Address - Phone:518-462-9120
Mailing Address - Fax:
Practice Address - Street 1:47 NEW SCOTLAND AVE # MC44
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3412
Practice Address - Country:US
Practice Address - Phone:518-262-5076
Practice Address - Fax:518-262-5082
Is Sole Proprietor?:No
Enumeration Date:2008-03-11
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01063037A207RC0000X, 207RI0011X
NY003164207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology