Individual provider Active NPI

Marina Haghour-Vwich

  • Student in an Organized Health Care Education/Training Program
  • Paramus, NJ
National Provider Identifier
1063612059
Registry record updated Nov 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
230 E Ridgewood Ave
Paramus, NJ 07652-4142
Phone
(201) 967-4000
NPI assigned
Jul 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

230 E Ridgewood Ave
Paramus, NJ 07652-4142

Mailing address

230 E Ridgewood Ave
Paramus, NJ 07652-4142
Phone (201) 967-4000

Other identifiers 1

IdentifierTypeStateIssuer
0237736MedicaidNJ

Other names 1

  • Dr. Marina Moh'D Haghour Other name

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
I20101116000493 NJ Practitioner - Psychiatry 5991990939 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08679700NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bergen County Improvement Authority CurrentSince Mar 23, 2019 Accepting new patients
Christian Health Care Center CurrentSince Jan 6, 2014 Accepting new patients
Wayne Behavioral Service, LLC CurrentSince Nov 1, 2011 Accepting new patients
Bergen County Improvement Authority CurrentSince Mar 23, 2019 Accepting new patients
Hudson Co Board of Chosen Freehold Admin CurrentSince Jan 1, 2020 Accepting new patients
Center of Revitalizing Psychiatry, P.C. PastSince Sep 28, 2025 Accepting new patients

Locations

230 E Ridgewood Ave
Paramus, NJ 07652
Phone (201) 225-4700

595 County Ave
Secaucus, NJ 07094
Phone (201) 369-5252

401 Hamburg Tpke
Ste 302
Wayne, NJ 07470
Phone (973) 790-9222

301 Sicomac Ave
Wyckoff, NJ 07481
Phone (201) 848-5200

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290988800000",
    "number": "1063612059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 E RIDGEWOOD AVE",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076524142",
            "telephone_number": "201-967-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E RIDGEWOOD AVE",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076524142",
            "telephone_number": "201-967-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGHOUR-VWICH",
        "first_name": "MARINA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-19",
        "last_updated": "2010-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0237736",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARINA",
            "last_name": "HAGHOUR",
            "middle_name": "MOH'D",
            "prefix": "DR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Paramus, NJ

Sources for this page

Verify at the official NPI Registry.