Healthcare Provider Details

I. General information

NPI: 1295469369
Provider Name (Legal Business Name): FIRSTLINE HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2022
Last Update Date: 09/21/2023
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 ELIZABETH AVE
ELIZABETH NJ
07201-2710
US

IV. Provider business mailing address

905 ELIZABETH AVE
ELIZABETH NJ
07201-2710
US

V. Phone/Fax

Practice location:
  • Phone: 908-591-6124
  • Fax: 908-352-0012
Mailing address:
  • Phone: 908-591-6124
  • Fax: 908-352-0012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: ISAAC K SOLIMAN
Title or Position: PRESIDENT
Credential:
Phone: 908-964-9355