Haitham R. Dib M.D. LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

HAITHAM R. DIB M.D. LLC

Practice address

436 Chris Gaupp Dr
Suite 204
Galloway, NJ 08205-4487

Phone

(609) 652-0100

Fax

(609) 652-7616

NPI assigned

Sep 27, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Haitham Riad Dib, MD

Title

Doctor/Owner

Phone

(609) 652-0100

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398124800000",
    "number": "1972694941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 CHRIS GAUPP DR",
            "address_2": "SUITE 204",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082054487",
            "telephone_number": "609-652-0100",
            "fax_number": "609-652-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 CHRIS GAUPP DR",
            "address_2": "SUITE 204",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082054487",
            "telephone_number": "609-652-0100",
            "fax_number": "609-652-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAITHAM R. DIB M.D. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2014-04-22",
        "status": "A",
        "authorized_official_last_name": "DIB",
        "authorized_official_first_name": "HAITHAM",
        "authorized_official_middle_name": "RIAD",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "609-652-0100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Galloway, NJ
• Providers in Galloway, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2014; 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.