Provider Demographics
NPI:1710654272
Name:HADASSAH SELENGUT
Entity Type:Organization
Organization Name:HADASSAH SELENGUT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HADASSAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SELENGUT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-856-5890
Mailing Address - Street 1:44 BARRY PL
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-3516
Mailing Address - Country:US
Mailing Address - Phone:973-777-0402
Mailing Address - Fax:
Practice Address - Street 1:254 PENNINGTON AVE
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-4645
Practice Address - Country:US
Practice Address - Phone:973-856-5890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech