Provider Demographics
NPI:1235833005
Name:HEMATOLOGY ONCOLOGY ASSOCIATES OF NORTH JERSEY, LLC
Entity Type:Organization
Organization Name:HEMATOLOGY ONCOLOGY ASSOCIATES OF NORTH JERSEY, LLC
Other - Org Name:DR. MOHTASEB'S CANCER CENTER AND BLOOD DISORDERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:HAMDY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOHTASEB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-361-3030
Mailing Address - Street 1:8905 S PECOS RD STE 23A
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7148
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8905 S PECOS RD STE 23A
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7148
Practice Address - Country:US
Practice Address - Phone:702-361-3030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEMATOLOGY ONCOLOGY ASSOCIATES OF NORTH JERSEY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty