Healthcare Provider Details

I. General information

NPI: 1376953851
Provider Name (Legal Business Name): BAYTUL- IMAN, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2014
Last Update Date: 05/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 LAUREL AVE
HAZLET TOWNSHIP NJ
07734-3023
US

IV. Provider business mailing address

428 MORRISTOWN RD
MATAWAN NJ
07747-3586
US

V. Phone/Fax

Practice location:
  • Phone: 732-207-5893
  • Fax:
Mailing address:
  • Phone: 732-207-5893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. WAHID SHIBLI
Title or Position: DIRECTOR BUSINESS DEVELOPMENT
Credential:
Phone: 732-207-5893