Individual provider Active NPI

Ibrahim A Housri, M.D.

  • Hematology (Internal Medicine) Physician
  • East Hanover, NJ
National Provider Identifier
1033222369
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology (Internal Medicine) PhysicianTaxonomy code 207RH0000X
Practice address
28 Tiffany Dr
East Hanover, NJ 07936-2516
Phone
(973) 887-3883
Fax
(973) 887-6306
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X NJ Primary

Addresses

Primary practice location

28 Tiffany Dr
East Hanover, NJ 07936-2516

Mailing address

28 Tiffany Dr
East Hanover, NJ 07936-2516
Phone (973) 887-3883

Other identifiers 1

IdentifierTypeStateIssuer
2952203MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080922000392 NJ Practitioner - Internal MedicinePractitioner - Hematology 4587731245 Practice locations: Jersey City, NJ; East Hanover, NJ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MAU2989600NJMDHematology (Internal Medicine) Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033222369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 TIFFANY DR",
            "city": "EAST HANOVER",
            "state": "NJ",
            "postal_code": "079362516",
            "telephone_number": "973-887-3883",
            "fax_number": "973-887-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 TIFFANY DR",
            "city": "EAST HANOVER",
            "state": "NJ",
            "postal_code": "079362516",
            "telephone_number": "973-887-3883",
            "fax_number": "973-887-6306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSRI",
        "first_name": "IBRAHIM",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2952203",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hanover, NJ

Sources for this page

Verify at the official NPI Registry.