Provider Demographics
NPI:1720745060
Name:HAMILTON BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:HAMILTON BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YASIR
Authorized Official - Middle Name:J
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-767-1013
Mailing Address - Street 1:79 OGLE RD
Mailing Address - Street 2:
Mailing Address - City:OLD TAPPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-7026
Mailing Address - Country:US
Mailing Address - Phone:302-526-4547
Mailing Address - Fax:302-469-2115
Practice Address - Street 1:79 OGLE RD
Practice Address - Street 2:
Practice Address - City:OLD TAPPAN
Practice Address - State:NJ
Practice Address - Zip Code:07675-7026
Practice Address - Country:US
Practice Address - Phone:201-490-5158
Practice Address - Fax:848-667-8981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-22
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty