Provider Demographics
NPI:1588028138
Name:HAJJAR, RICHARD AUSTIN (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:AUSTIN
Last Name:HAJJAR
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 1:43 YAWPO AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07436-2736
Mailing Address - Country:US
Mailing Address - Phone:201-337-0066
Mailing Address - Fax:
Practice Address - Street 1:43 YAWPO AVE STE 2
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:NJ
Practice Address - Zip Code:07436-2736
Practice Address - Country:US
Practice Address - Phone:201-337-0066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-11
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ25MA106900207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program