Dr. Bassam N Odatalla, MD
Family Medicine in Fairfield, New Jersey
1063620060- Practice location
- 200 Fairfield RD, Fairfield, NJ 07004-2426
- Phone
- 973-487-1944
- Fax
- 973-487-1945
- Last updated
- August 19, 2015
Bassam N Odatalla is a Family Medicine based in Fairfield, NJ. Bassam N Odatalla practices in Fairfield, NJ and has the professional credentials of MD. The NPI Number for Bassam N Odatalla is 1063620060 and holds a License No. 08610800 (NJ). The current practice location address for Bassam N Odatalla is 200 Fairfield RD, Fairfield, NJ 07004-2426 and can be reached out via phone at 973-487-1944 and via fax at 973-487-1945.
Provider Profile Details
- NPI Number
- 1063620060
- Provider Name
- Bassam N Odatalla
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 200 Fairfield RD, Fairfield, NJ 07004-2426
- Phone Number
- 973-487-1944
- Fax Number
- 973-487-1945
- Primary Taxonomy
- Family Medicine · 207Q00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- May 21, 2007
- Last Update Date
- August 19, 2015
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 200 Fairfield RD
Fairfield, NJ 07004-2426 - City
- Fairfield
- State
- New Jersey
- Zip
- 07004-2426
- Phone Number
- 973-487-1944
- Fax Number
- 973-487-1945
Provider Business Mailing Address Details
- Address
- 200 Fairfield RD
Fairfield, NJ 07004-2426 - City
- Fairfield
- State
- NJ
- Zip
- 07004-2426
- Phone Number
- 973-487-1944
- Fax Number
- 973-487-1945
License Information
- License Number
- 08610800
- License State
- NJ
- Taxonomy
- Family Medicine · 207Q00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Dr. Bassam N Odatalla, MD?
The NPI number of Dr. Bassam N Odatalla, MD is 1063620060. It was assigned on May 21, 2007 and is currently active in the NPPES registry.
What is the specialty of Dr. Bassam N Odatalla, MD?
Dr. Bassam N Odatalla, MD is registered under the primary taxonomy Family Medicine (code 207Q00000X), licensed in NJ under license number 08610800.
Where does Dr. Bassam N Odatalla, MD practice?
The practice location is 200 Fairfield RD, Fairfield, NJ 07004-2426. The office can be reached at 973-487-1944 (phone) or 973-487-1945 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1063620060 directly on the NPPES registry website.