Provider Demographics
NPI:1073949780
Name:HAJJ, SAMAR J (MD)
Entity Type:Individual
Prefix:
First Name:SAMAR
Middle Name:J
Last Name:HAJJ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:579A CRANBURY RD
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5426
Mailing Address - Country:US
Mailing Address - Phone:732-390-0040
Mailing Address - Fax:
Practice Address - Street 1:579A CRANBURY RD
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5426
Practice Address - Country:US
Practice Address - Phone:732-390-0040
Practice Address - Fax:732-955-8874
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-25
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA117541002085N0700X, 207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC092223206Medicaid
MD500275300Medicaid