Provider Demographics
NPI:1194724310
Name:HAMMERMAN, LOUIS (MD)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:
Last Name:HAMMERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 HAWKINS PL
Mailing Address - Street 2:
Mailing Address - City:BOONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07005-1128
Mailing Address - Country:US
Mailing Address - Phone:973-334-3006
Mailing Address - Fax:973-402-9778
Practice Address - Street 1:360 HAWKINS PL
Practice Address - Street 2:
Practice Address - City:BOONTON
Practice Address - State:NJ
Practice Address - Zip Code:07005-1128
Practice Address - Country:US
Practice Address - Phone:973-334-3006
Practice Address - Fax:973-402-9778
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03896400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
78371OtherUSHC
NJ1952901Medicaid
NJ412270MOtherCIGNA
C55715Medicare UPIN
NJ1952901Medicaid