Provider Demographics
NPI:1306838164
Name:HAMATY, JOHN N (DO)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:N
Last Name:HAMATY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 CHAPEL AVE W
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-1592
Mailing Address - Country:US
Mailing Address - Phone:856-482-8900
Mailing Address - Fax:
Practice Address - Street 1:1 BRACE RD STE C
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2600
Practice Address - Country:US
Practice Address - Phone:856-428-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB05483100207RC0000X
PAOS006860L207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6199305Medicaid
NJ6199305Medicaid
NJ50128YZEZMedicare PIN