Provider Demographics
NPI:1659552362
Name:HJAZI HEALTH CARE P.L.L.C.
Entity Type:Organization
Organization Name:HJAZI HEALTH CARE P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:IZAT
Authorized Official - Middle Name:K
Authorized Official - Last Name:AL-BACHA HJAZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-324-5052
Mailing Address - Street 1:1124 CREASE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19125-4108
Mailing Address - Country:US
Mailing Address - Phone:215-324-5052
Mailing Address - Fax:888-863-8840
Practice Address - Street 1:927 HUNTINGDON PIKE STE 1
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-8359
Practice Address - Country:US
Practice Address - Phone:215-324-5052
Practice Address - Fax:215-324-5080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-21
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD432731261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care