Provider Demographics
NPI:1457112484
Name:VIP RHEUMATOLOGY
Entity Type:Organization
Organization Name:VIP RHEUMATOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAIJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-567-4386
Mailing Address - Street 1:200 CENTURY PKWY STE D
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-1150
Mailing Address - Country:US
Mailing Address - Phone:856-567-4386
Mailing Address - Fax:866-493-3717
Practice Address - Street 1:200 CENTURY PKWY STE D
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-1150
Practice Address - Country:US
Practice Address - Phone:856-567-4386
Practice Address - Fax:866-493-3717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-17
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty