Provider Demographics
NPI:1215096706
Name:HEDONEIA C. JAAJ, MD
Entity type:Organization
Organization Name:HEDONEIA C. JAAJ, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEDONEIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:JAAJ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-838-0714
Mailing Address - Street 1:34 MAIN ST # A
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07403-1724
Mailing Address - Country:US
Mailing Address - Phone:973-838-0714
Mailing Address - Fax:973-838-7940
Practice Address - Street 1:34 MAIN ST # A
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:NJ
Practice Address - Zip Code:07403-1724
Practice Address - Country:US
Practice Address - Phone:973-838-0714
Practice Address - Fax:973-838-7940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04235000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC56550Medicare UPIN
NJ504998Medicare ID - Type Unspecified