Ibrahim William Sidhom M.D.,P.C.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

MA50525 Issued in NJ

Legal business name

IBRAHIM WILLIAM SIDHOM M.D.,P.C.

Practice address

48 Pulaski Ave
Carteret, NJ 07008-2509

Phone

(732) 541-5595

NPI assigned

May 6, 2008

Organization subpart

No

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

Authorized official

Name

Ibrahim William Sidhom, M.D.NPI 1851301220

Title

President

Phone

(732) 541-5595

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ibrahim William Sidhom, MD

  • Hematology & Oncology Physician
  • Carteret, NJ
  • NPI 1851301220
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210032000000",
    "number": "1275709511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 PULASKI AVE",
            "city": "CARTERET",
            "state": "NJ",
            "postal_code": "070082509",
            "telephone_number": "732-541-5595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 PULASKI AVE",
            "city": "CARTERET",
            "state": "NJ",
            "postal_code": "070082509",
            "telephone_number": "732-541-5595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IBRAHIM WILLIAM SIDHOM M.D.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-06",
        "last_updated": "2008-05-06",
        "status": "A",
        "authorized_official_last_name": "SIDHOM",
        "authorized_official_first_name": "IBRAHIM",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-541-5595",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NJ",
            "license": "MA50525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7530803",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Carteret, NJ
• Providers in Carteret, NJ by specialty
• Medical Specialty Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.