Provider Demographics
NPI:1689858011
Name:ABDELHADI, SAMIR ISA (DO)
Entity Type:Individual
Prefix:DR
First Name:SAMIR
Middle Name:ISA
Last Name:ABDELHADI
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 1:103 RIVER RD
Mailing Address - Street 2:STE 101
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1016
Mailing Address - Country:US
Mailing Address - Phone:973-972-6111
Mailing Address - Fax:
Practice Address - Street 1:103 RIVER RD
Practice Address - Street 2:STE 101
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-1016
Practice Address - Country:US
Practice Address - Phone:201-308-8995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-20
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08398600207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine