Provider Demographics
NPI:1174537419
Name:MESSIHI, JEAN N (MD)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:N
Last Name:MESSIHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 14TH ST
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-5545
Mailing Address - Country:US
Mailing Address - Phone:201-656-8353
Mailing Address - Fax:201-656-8116
Practice Address - Street 1:113 14TH ST
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-5545
Practice Address - Country:US
Practice Address - Phone:201-656-8353
Practice Address - Fax:201-656-8116
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA33186207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
C55560Medicare UPIN
454149Medicare ID - Type Unspecified