Provider Demographics
NPI:1265754105
Name:FREDERIQUE DELHAYE M.D. :P.C.
Entity type:Organization
Organization Name:FREDERIQUE DELHAYE M.D. :P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERIQUE
Authorized Official - Middle Name:P
Authorized Official - Last Name:DELHAYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-422-4144
Mailing Address - Street 1:1626 RTE 130 STE J
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-3035
Mailing Address - Country:US
Mailing Address - Phone:732-422-4144
Mailing Address - Fax:732-422-4468
Practice Address - Street 1:1626 RT 130 NORTH
Practice Address - Street 2:SUITE J
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-3051
Practice Address - Country:US
Practice Address - Phone:732-422-4144
Practice Address - Fax:732-422-4468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04868500261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ665794OtherPTAN