Healthcare Provider Details

I. General information

NPI: 1316234859
Provider Name (Legal Business Name): AMERICAN PHARMA TRADE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2011
Last Update Date: 07/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 SAINT GERMAIN DR
CLARK NJ
07066-2621
US

IV. Provider business mailing address

99 SAINT GERMAIN DR
CLARK NJ
07066-2621
US

V. Phone/Fax

Practice location:
  • Phone: 732-428-5553
  • Fax:
Mailing address:
  • Phone: 732-428-5553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: MR. JAY ABDEO
Title or Position: PRESIDENT
Credential:
Phone: 732-428-5553