Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 254409 | NY |
N | 111NI0900X | Internist | 254409 | NY |
Y | 207R00000X | Internist | 25MA08680300 | NJ |
Y | 111NI0900X | Internist | 25MA08680300 | NJ |
NPI | 1891956876 |
---|---|
Provider Name | Marwa Mohamed Hazzah |
First Address | Lyndhurst, NJ 07071-1217 |
Second Address | Lyndhurst, NJ 07071-1217 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2008 |
Last Update Date | 23/03/2021 |