Doctor Name: | DR. IBRAHIM WILLIAM SIDHOM |
NPI Number: | 1851301220 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | MA50525 |
Business Practice Address: | 48 Pulaski Ave Carteret, NJ - 070082509 |
Business Phone Number: | 7325415595 |
Business Fax Number: | 7325411451 |
Mailing Address: | 48 Pulaski Ave, CARTERET |
State: | NJ |
Postal Code: | 070082509 |
Phone Number: | 7325415595 |
Fax Number: | 7325411451 |
NPI Enumeration Date: | 08/09/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207RH0003X |
License Number: | MA50525 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Internal Medicine |
Taxonomy Specialization: | Hematology & Oncology |
Taxonomy Definition: | An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |