Provider Demographics
NPI:1861659310
Name:HANIF, BASHIR (MD)
Entity Type:Individual
Prefix:
First Name:BASHIR
Middle Name:
Last Name:HANIF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2073 KLOCKNER RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-3414
Mailing Address - Country:US
Mailing Address - Phone:609-631-7108
Mailing Address - Fax:609-586-3161
Practice Address - Street 1:2073 KLOCKNER RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-3414
Practice Address - Country:US
Practice Address - Phone:609-584-1212
Practice Address - Fax:609-584-0103
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06505400207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ82201600Medicaid
NJ037891Medicare PIN
NJH15776Medicare UPIN