Healthcare Provider Details

I. General information

NPI: 1023411311
Provider Name (Legal Business Name): ALPINE MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2014
Last Update Date: 12/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

634 SUMMIT AVE
JERSEY CITY NJ
07306-3705
US

IV. Provider business mailing address

634 SUMMIT AVE
JERSEY CITY NJ
07306-3705
US

V. Phone/Fax

Practice location:
  • Phone: 201-222-9370
  • Fax: 201-222-9392
Mailing address:
  • Phone: 201-222-9370
  • Fax: 201-222-9392

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 Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. AMER K SYED
Title or Position: PRESIDENT
Credential: MD
Phone: 201-222-9370