Provider Demographics
NPI:1902852858
Name:HORIZON HEMATOLOGY/ONCOLOGY CORP
Entity Type:Organization
Organization Name:HORIZON HEMATOLOGY/ONCOLOGY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REYAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-790-3433
Mailing Address - Street 1:PO BOX 4630
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07474-4630
Mailing Address - Country:US
Mailing Address - Phone:201-512-9494
Mailing Address - Fax:
Practice Address - Street 1:508 HAMBURG TPKE
Practice Address - Street 2:SUITE 202
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-8482
Practice Address - Country:US
Practice Address - Phone:973-790-3433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA62887207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7046707Medicaid
NJ893003Medicare ID - Type Unspecified
NJ7046707Medicaid