Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | NJ |
NPI | 1033222369 |
---|---|
Provider Name | Dr. Ibrahim A Housri |
First Address | East Hanover, NJ 07936-2516 |
Second Address | East Hanover, NJ 07936-2516 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2952203 | (05) | NJ |
C56189 | (02) |