Provider Demographics
NPI:1639349285
Name:JOHN J HOSAY MD PA
Entity Type:Organization
Organization Name:JOHN J HOSAY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOSAY JR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-433-9666
Mailing Address - Street 1:2555 KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-2165
Mailing Address - Country:US
Mailing Address - Phone:201-433-9666
Mailing Address - Fax:201-432-9647
Practice Address - Street 1:2555 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-2165
Practice Address - Country:US
Practice Address - Phone:201-433-9666
Practice Address - Fax:201-432-9647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-10
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03641100208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2679809OtherMEDICAID GROUP #
NJ1862201Medicaid
NJ028015Medicare PIN