Provider Demographics
NPI:1922162122
Name:HOZAYEN, OSSAMA A (MD)
Entity Type:Individual
Prefix:
First Name:OSSAMA
Middle Name:A
Last Name:HOZAYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 384
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-0384
Mailing Address - Country:US
Mailing Address - Phone:732-264-5005
Mailing Address - Fax:732-264-1843
Practice Address - Street 1:1 BETHANY RD
Practice Address - Street 2:SUITE 85, BUILDING 6
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1663
Practice Address - Country:US
Practice Address - Phone:732-264-5005
Practice Address - Fax:732-264-1843
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA070813207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH11800Medicare UPIN