Provider Demographics
NPI:1093890303
Name:HOLLANDER, JASON (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:HOLLANDER
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 1:168 FRANKLIN CORNER RD BLDG 1
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2529
Mailing Address - Country:US
Mailing Address - Phone:609-924-4433
Mailing Address - Fax:609-924-4423
Practice Address - Street 1:168 FRANKLIN CORNER RD BLDG 1
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2529
Practice Address - Country:US
Practice Address - Phone:609-924-4433
Practice Address - Fax:609-924-4423
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY110218311207R00000X, 208000000X
NY218311207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY147AM1Medicare PIN
NYH93024Medicare UPIN