Provider Demographics
NPI:1972975142
Name:NEIHA, LLC
Entity type:Organization
Organization Name:NEIHA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NADER
Authorized Official - Middle Name:
Authorized Official - Last Name:MOAVEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-759-1221
Mailing Address - Street 1:264 BOYDEN AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-3070
Mailing Address - Country:US
Mailing Address - Phone:973-759-1221
Mailing Address - Fax:973-759-1997
Practice Address - Street 1:264 BOYDEN AVE
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-3070
Practice Address - Country:US
Practice Address - Phone:973-759-1221
Practice Address - Fax:973-759-1997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05812900207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty