HEMATOLOGY ONCOLOGY ASSOCIATES OF NORTH JERSEY, LLC (NPI# 1972776672) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972776672 |
| Entity Type | Organization |
| Organization Name | HEMATOLOGY ONCOLOGY ASSOCIATES OF NORTH JERSEY, LLC |
| Other Organization Name | DR. MOHTASEB'S CANCER CENTER AND BLOOD DISORDERS |
| Practice Address |
1755 Airway Avenue Kingman AZ 86409 |
| Mailing Address |
3900 Stockton Hill Rd Suite B368 Kingman AZ 86409-3029 |
| Practice Telephone | 9286811234 |
| Practice Fax Number | 9286811811 |
| Mailing Telephone | 9286811234 |
| Mailing Fax Number | 9286811811 |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2012-08-09 |
| Authorized Official Name | DR. HAMDY A MOHTASEB (PRESIDENT/MEMBER) |
| Authorized Official Telephone | 9286811234 |
| Authorized Official Credential | MD, FACP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 6441700001 | AZ | Suppliers |
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE ID TYPE UNSPECIF | 044000 | 01 | |
| NJ | 6670901 | 05 | |
| NJ | NJ LICENSE | MA61425 | 01 |
| Other Name | Type Code |
|---|---|
| Dr. Mohtaseb's Cancer Center And Blood Disorders | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700483252 | Hematology Oncology Associates of North Jersey, LLC | Internal Medicine | 1225 Hancock Rd, Suite 204, Bullhead City, AZ 86442 | 2020-10-07 |
| 1881078889 | Hematology Oncology Associates of North Jersey, LLC | Internal Medicine | 5225 S Highway 95, Suite 6, Fort Mohave, AZ 86426-9111 | 2015-07-20 |
| Street Address |
1755 AIRWAY AVENUE |
| City | KINGMAN |
| State | AZ |
| Zip Code | 86409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164423257 | Hamdy A Mohtaseb | Internal Medicine | 1755 Airway Avenue, Kingman, AZ 86409 | 2005-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437695731 | Medical Laboratory Specialty, Inc | Clinical Medical Laboratory | 3636 St, Kingman, AZ 86409 | 2017-01-10 |
| 1003219007 | Premier Home Health Agency | Home Health | 3555 Western Ave, Kingman, AZ 86409 | 2014-10-03 |
| 1558774984 | Fernando Velez | Pharmacist | 2003 Roy Rogers Way, Kingman, AZ 86409 | 2014-06-03 |
| 1013227834 | Route 66 Cab Inc | Taxi | 3595 E Us Highway 66, Kingman, AZ 86409 | 2010-10-14 |
| 1740503374 | Route 66 Cab Inc. | Taxi | 3595 East Hwy 66, Kingman, AZ 86409 | 2010-03-10 |
| 1649409145 | Arizona Cvs Stores, L.L.C. | Durable Medical Equipment & Medical Supplies | 3501 Stockton Hill Rd, Kingman, AZ 86409 | 2009-07-07 |
| 1790922896 | Jack Cheng-tsung Hou | Urology | 1739 E Beverly Ave Ste 106, Kingman, AZ 86409 | 2009-01-12 |
| 1710184726 | Michele F Epstein | Internal Medicine | 3571 N Moore Street, Kingman, AZ 86409 | 2007-07-02 |
| 1013118306 | Conchita O Mercado | Dentist | 1101 Riata Valley Rd, Kingman, AZ 86409 | 2007-05-31 |
| 1366585945 | Deering Therapy Services Ltd | Occupational Therapist | 1841 Morrow Ave, Kingman, AZ 86409 | 2007-02-14 |
| Find all providers in zip 86409 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| 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. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912158221 | Cancer Center of Kansas, P.a. | Internal Medicine | 750 Avenue D, Kingman, KS 67068-0376 | 2008-10-06 |
| 1386834844 | Mohave Medical Oncology Center | Internal Medicine | 3801 Santa Rosa, Suite 200, Kingman, AZ 86401-2311 | 2007-07-30 |
| 1164423257 | Hamdy A Mohtaseb | Internal Medicine | 1755 Airway Avenue, Kingman, AZ 86409 | 2005-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740700798 | Iloabueke Gabriel Chineke | Internal Medicine | 3838 N. Campbell Ave, Tucson, AZ 85719-1454 | 2017-06-21 |
| 1699035717 | Robert Dukjun Yoo | Internal Medicine | 1432 S Dobson Rd Ste 106, Mesa, AZ 85202 | 2012-05-22 |
| 1548538499 | Robert David Ligorsky | Internal Medicine | 11035 E Acoma Dr, Scottsdale, AZ 85255-1865 | 2011-12-07 |
| 1972895340 | Abhishek Harshad Patel | Internal Medicine | 5750 W Thunderbird Rd Ste C300, Glendale, AZ 85306-4666 | 2011-05-04 |
| 1487989927 | Clevius Arnold Curry | Internal Medicine | 10500 E Lost Canyon Dr Lot 8, Scottsdale, AZ 85255-4454 | 2009-10-15 |
| 1972746287 | Keerti Khandelwal | Internal Medicine | 1951 W 25th St Ste F, Yuma, AZ 85364-6924 | 2009-04-16 |
| 1336384809 | Irwin W Tischler | Internal Medicine | 4638 E Berneil Dr, Phoenix, AZ 85028-5500 | 2008-12-11 |
| 1205086378 | Desert Springs Cancer Care, P.l.c. | Internal Medicine | 8950 S 52nd St, Suite 101, Tempe, AZ 85284-1046 | 2008-09-25 |
| 1114182185 | Maria Mercedes Brenneisen | Internal Medicine | 21600 W El Grande Trl, Wickenburg, AZ 85390-3476 | 2008-07-18 |
| 1568625077 | Lida A Mina | Internal Medicine | 2940 E. Banner Gateway Dr., Gilbert, AZ 85234 | 2008-07-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.