Healthcare Provider Details

I. General information

NPI: 1639601024
Provider Name (Legal Business Name): PARAMUS MULTICARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 04/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152 CENTRAL AVE
CLARK NJ
07066-1115
US

IV. Provider business mailing address

152 CENTRAL AVE
CLARK NJ
07066-1115
US

V. Phone/Fax

Practice location:
  • Phone: 732-726-0020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SAJ KHAN
Title or Position: MANAGER
Credential:
Phone: 732-726-0020