Jersey Health Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MA05217700 Issued in NJ

Legal business name

JERSEY HEALTH CLINIC

Practice address

79 Nelson Ave
Jersey City, NJ 07307-4006

Phone

(201) 855-1200

Fax

(201) 967-8443

NPI assigned

Jun 17, 2011

Organization subpart

No

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

Authorized official

Name

Gamal K Hanna, M.D.

Title

MD

Phone

(201) 967-8425

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308268800000",
    "number": "1598050452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8265",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070478265",
            "telephone_number": "201-855-1200",
            "fax_number": "201-967-8425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 NELSON AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073074006",
            "telephone_number": "201-855-1200",
            "fax_number": "201-967-8443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-17",
        "last_updated": "2011-06-17",
        "status": "A",
        "authorized_official_last_name": "HANNA",
        "authorized_official_first_name": "GAMAL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "201-967-8425",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA05217700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1884808",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jersey Dental Arts PA
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• Jersey Emergency Medical Associates LLC
• Jersey Eye Care Inc
• Jersey Family Medicine PC
• Jersey Healthcare Services PC
• Jersey Heights Dental Care, LLC
• Jersey Integrative Sports & Spine
• Jersey Liberty Radiology, LLC
• Jersey Liberty Radiology, P.C.

• Family Medicine Physician in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.