Provider Demographics
NPI:1114707734
Name:MERCER COUNTY HYPERTENSION CLINIC LLC
Entity Type:Organization
Organization Name:MERCER COUNTY HYPERTENSION CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AFSHIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-585-1344
Mailing Address - Street 1:PO BOX 8422
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08650-0422
Mailing Address - Country:US
Mailing Address - Phone:609-585-1344
Mailing Address - Fax:
Practice Address - Street 1:1345 KUSER RD STE 2
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3823
Practice Address - Country:US
Practice Address - Phone:609-585-1344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0005XAllopathic & Osteopathic PhysiciansInternal MedicineHypertension SpecialistGroup - Single Specialty