Provider Demographics
NPI:1821088915
Name:NEW JERSEY HEMATOLOGY ONCOLOGY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:NEW JERSEY HEMATOLOGY ONCOLOGY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOEVY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-840-8880
Mailing Address - Street 1:1608 ROUTE 88 W
Mailing Address - Street 2:STE 250
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-3009
Mailing Address - Country:US
Mailing Address - Phone:732-840-8880
Mailing Address - Fax:732-840-3939
Practice Address - Street 1:1608 ROUTE 88 W
Practice Address - Street 2:STE 250
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3009
Practice Address - Country:US
Practice Address - Phone:732-840-8880
Practice Address - Fax:732-840-3939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-28
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06311400174400000X
NJ25MB04677600174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2337188OtherAETNA
NJ5100339OtherGHI
NJ039592Medicare ID - Type Unspecified