Healthcare Provider Details

I. General information

NPI: 1013514447
Provider Name (Legal Business Name): ALDAD MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2020
Last Update Date: 03/28/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 N SANGAMON ST STE 200&300
CHICAGO IL
60607-2201
US

IV. Provider business mailing address

510 HEMPSTEAD TPKE RM 203
WEST HEMPSTEAD NY
11552-1152
US

V. Phone/Fax

Practice location:
  • Phone: 516-505-7200
  • Fax:
Mailing address:
  • Phone: 516-559-4041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: TAMIR ALDAD
Title or Position: PRESIDENT
Credential:
Phone: 516-505-7200