Provider Demographics
NPI:1215786447
Name:HISHAM HASHISH CORPORATION
Entity type:Organization
Organization Name:HISHAM HASHISH CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HISHAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:A HASHISH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-249-8513
Mailing Address - Street 1:1092 CHEWS LANDING RD
Mailing Address - Street 2:
Mailing Address - City:CLEMENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-2958
Mailing Address - Country:US
Mailing Address - Phone:856-249-8513
Mailing Address - Fax:856-994-1018
Practice Address - Street 1:297 WESTWOOD DR STE 103
Practice Address - Street 2:
Practice Address - City:WEST DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08096-3144
Practice Address - Country:US
Practice Address - Phone:856-249-8513
Practice Address - Fax:856-994-1018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty