Healthcare Provider Details

I. General information

NPI: 1174784953
Provider Name (Legal Business Name): ALDAD MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S 1ST ST
ANN ARBOR MI
48104-1306
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 Number157937
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

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