Provider Demographics
NPI:1336275288
Name:LAHITA, ROBERT GEORGE (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:GEORGE
Last Name:LAHITA
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07503-2621
Mailing Address - Country:US
Mailing Address - Phone:973-754-2476
Mailing Address - Fax:973-754-5475
Practice Address - Street 1:234 HAMBURG TPKE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2173
Practice Address - Country:US
Practice Address - Phone:973-754-4175
Practice Address - Fax:973-389-6031
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04908500207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP1250305OtherOXFORD
NJP00169724OtherRAILROAD MEDICARE
NJ0028525Medicaid
NY00680364Medicaid
NJ60017174OtherHORIZON NJ HEALTH
NY81V012Medicare ID - Type Unspecified
NJA61150Medicare UPIN
NY00680364Medicaid