Provider Demographics
NPI:1114907557
Name:BATARSEH, HANI (MD)
Entity Type:Individual
Prefix:DR
First Name:HANI
Middle Name:
Last Name:BATARSEH
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 1:540 BORDENTOWN AVE
Mailing Address - Street 2:SUITE 2100
Mailing Address - City:SOUTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08879-1544
Mailing Address - Country:US
Mailing Address - Phone:732-721-1500
Mailing Address - Fax:
Practice Address - Street 1:540 BORDENTOWN AVE
Practice Address - Street 2:SUITE 2100
Practice Address - City:SOUTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08879-1544
Practice Address - Country:US
Practice Address - Phone:732-721-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-20
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA072459207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8889007Medicaid
NJ059502Medicare PIN