Healthcare Provider Details

I. General information

NPI: 1932141256
Provider Name (Legal Business Name): MDSLIM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 OVERLOOK AVENUE
HACKENSACK NJ
07601-2206
US

IV. Provider business mailing address

150 OVERLOOK AVENUE
HACKENSACK NJ
07601-2206
US

V. Phone/Fax

Practice location:
  • Phone: 201-487-8010
  • Fax: 201-487-7010
Mailing address:
  • Phone: 201-487-8010
  • Fax: 201-487-7010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANJANA CHHABRA
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 201-487-8010