Healthcare Provider Details

I. General information

NPI: 1093698326
Provider Name (Legal Business Name): PALAK JAY MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2025
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 PROSPECT AVE STE 112
HACKENSACK NJ
07601-2570
US

IV. Provider business mailing address

7000 KENNEDY BLVD E APT 50G
WEST NEW YORK NJ
07093-4865
US

V. Phone/Fax

Practice location:
  • Phone: 908-510-0949
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
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: PALAK OZA
Title or Position: PROVIDER
Credential: MD
Phone: 908-510-0949