Basic Information
Provider Information
NPI: 1801250345
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUNTER
FirstName: JANAE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 DIAMOND HILL RD
Address2:  
City: BERKELEY HEIGHTS
State: NJ
PostalCode: 079222104
CountryCode: US
TelephoneNumber: 9082734300
FaxNumber:  
Practice Location
Address1: 67 WALNUT AVE STE 202
Address2:  
City: CLARK
State: NJ
PostalCode: 070661640
CountryCode: US
TelephoneNumber: 7323887300
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/11/2016
LastUpdateDate: 06/10/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/10/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X25MA10764700NJY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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