Provider Demographics
NPI:1285756882
Name:ZIAD HADAYA
Entity type:Organization
Organization Name:ZIAD HADAYA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:Z
Authorized Official - Middle Name:
Authorized Official - Last Name:HADAYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-585-4100
Mailing Address - Street 1:994 WHITE HORSE AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08610-1428
Mailing Address - Country:US
Mailing Address - Phone:609-585-4100
Mailing Address - Fax:
Practice Address - Street 1:994 WHITE HORSE AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08610-1428
Practice Address - Country:US
Practice Address - Phone:609-585-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA41052207R00000X
NJMA46260207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========OtherHORIZON
NJ686271Medicare PIN