Healthcare Provider Details

I. General information

NPI: 1639606916
Provider Name (Legal Business Name): PHOENIX BUSINESS SOLUTIONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2017
Last Update Date: 05/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

277 PROSPECT AVE
HACKENSACK NJ
07601-2512
US

IV. Provider business mailing address

277 PROSPECT AVE
HACKENSACK NJ
07601-2512
US

V. Phone/Fax

Practice location:
  • Phone: 917-848-6362
  • Fax: 917-848-6362
Mailing address:
  • Phone: 917-848-6362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. ABDUL RAUF
Title or Position: CEO
Credential:
Phone: 917-848-6362