Provider Demographics
NPI:1487310447
Name:PANTHER HEALTHCARE CLINIC INC
Entity type:Organization
Organization Name:PANTHER HEALTHCARE CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:NADEAR
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:908-852-8818
Mailing Address - Street 1:PO BOX 399
Mailing Address - Street 2:
Mailing Address - City:ALLAMUCHY
Mailing Address - State:NJ
Mailing Address - Zip Code:07820-0399
Mailing Address - Country:US
Mailing Address - Phone:908-852-8818
Mailing Address - Fax:908-852-8775
Practice Address - Street 1:RT 517 VILLAGE SQUARE
Practice Address - Street 2:
Practice Address - City:ALLAMUCHY
Practice Address - State:NJ
Practice Address - Zip Code:07820
Practice Address - Country:US
Practice Address - Phone:908-852-8818
Practice Address - Fax:908-852-8775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-15
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty