| Organization Name: | HACKENSACK UNIVERSITY MEDICAL GROUP, PC |
| NPI Number: | 1215989249 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | IHOR S SAWCZUK (PRESIDENT) |
| Mailing Address: | 30 Prospect Ave Faculty Practice, Trailer Hackensack |
| State: | NJ US |
| Postal Code: | 076011914 |
| Phone Number: | 5519962816 |
| Fax Number: | 5519960855 |
| NPI Enumeration Date: | 05/17/2006 |
| NPI Last Update Date: | 10/09/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204F00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Transplant Surgery |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |