Provider Demographics
NPI:1528349701
Name:NORTH JERSEY VEIN LASER CENTER,PA
Entity type:Organization
Organization Name:NORTH JERSEY VEIN LASER CENTER,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZIAD
Authorized Official - Middle Name:
Authorized Official - Last Name:HADAYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-585-4100
Mailing Address - Street 1:994 WHITE HORSE AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08610-1428
Mailing Address - Country:US
Mailing Address - Phone:609-585-4100
Mailing Address - Fax:609-585-4106
Practice Address - Street 1:8901 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-5344
Practice Address - Country:US
Practice Address - Phone:201-453-8900
Practice Address - Fax:201-453-8903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-01
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty