Organization Name: | OLD HOOK MEDICAL ASSOCIATES, LLC |
NPI Number: | 1225370356 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KENNY HEINE (VP OF OPERATIONS) |
Mailing Address: | 452 Old Hook Rd Floor 2 Emerson |
State: | NJ US |
Postal Code: | 076301381 |
Phone Number: | 2016663900 |
Fax Number: | |
NPI Enumeration Date: | 03/27/2013 |
NPI Last Update Date: | 05/07/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332900000X |
License Number: | 25MA04377200 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Non-Pharmacy Dispensing Site |
Taxonomy Specialization: | |
Taxonomy Definition: | A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |