Healthcare Provider Details

I. General information

NPI: 1043722853
Provider Name (Legal Business Name): GOLD STANDARD MEDICAL GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2017
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1136 CLIFTON AVE FL 2
CLIFTON NJ
07013-3622
US

IV. Provider business mailing address

468 W SADDLE RIVER RD
UPPER SADDLE RIVER NJ
07458-1626
US

V. Phone/Fax

Practice location:
  • Phone: 862-249-1266
  • Fax: 862-249-1267
Mailing address:
  • Phone: 862-249-1266
  • Fax: 862-249-1267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. MUHAMMAD FARHAN IJAZ
Title or Position: PRESIDENT
Credential: MD
Phone: 551-486-1385