Provider Demographics
NPI:1134655491
Name:ALBANDAR, HAZEM (MD)
Entity type:Individual
Prefix:
First Name:HAZEM
Middle Name:
Last Name:ALBANDAR
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 1:1750 SLAYTON DR
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-3461
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4011 GATEWAY BLVD
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-8947
Practice Address - Country:US
Practice Address - Phone:812-490-4570
Practice Address - Fax:812-477-1595
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-05
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC228198390200000X
IN01087446A2084N0400X, 2084E0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2084E0001XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyEpilepsyGroup - Multi-Specialty