Provider Demographics
NPI:1285718817
Name:HASHISH, HISHAM (MD)
Entity type:Individual
Prefix:
First Name:HISHAM
Middle Name:
Last Name:HASHISH
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 1:33 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432-1401
Mailing Address - Country:US
Mailing Address - Phone:201-848-8000
Mailing Address - Fax:201-625-6464
Practice Address - Street 1:33 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07432-1401
Practice Address - Country:US
Practice Address - Phone:201-848-8000
Practice Address - Fax:201-625-6464
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA08688500207Q00000X, 208VP0000X
NMMD2008-0633207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM400045Medicare PIN
NMNMB2194Medicare PIN