Healthcare Provider Details

I. General information

NPI: 1760622955
Provider Name (Legal Business Name): IMMEDIHEALTH & WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2009
Last Update Date: 02/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 LOWER NOTCH RD
LITTLE FALLS NJ
07424-1802
US

IV. Provider business mailing address

201 LOWER NOTCH RD
LITTLE FALLS NJ
07424-1802
US

V. Phone/Fax

Practice location:
  • Phone: 973-714-2688
  • Fax: 973-777-8929
Mailing address:
  • Phone: 973-714-2688
  • Fax: 973-777-8929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ISHAK SOLIMAN
Title or Position: OWNER/PRESIDENT
Credential: M.D.
Phone: 973-714-2730