Provider Demographics
NPI:1184698151
Name:HAMADEH, RANDA MOUNAH (MD)
Entity type:Individual
Prefix:DR
First Name:RANDA
Middle Name:MOUNAH
Last Name:HAMADEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:988 BROADWAY STE 201
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-4036
Mailing Address - Country:US
Mailing Address - Phone:201-339-6111
Mailing Address - Fax:201-339-6333
Practice Address - Street 1:988 BROADWAY STE 201
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-4036
Practice Address - Country:US
Practice Address - Phone:201-339-6111
Practice Address - Fax:201-339-6333
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-15
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199146207RI0200X, 207R00000X
NJ25MA06984700207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY840121Medicare PIN