Healthcare Provider Details

I. General information

NPI: 1457594004
Provider Name (Legal Business Name): AMISH ATULBHAI NAIK M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2009
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S ORANGE AVE STE 230
LIVINGSTON NJ
07039-5817
US

IV. Provider business mailing address

1992 MORRIS AVE PMB 348
UNION NJ
07083
US

V. Phone/Fax

Practice location:
  • Phone: 201-716-5850
  • Fax:
Mailing address:
  • Phone: 973-440-3444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number25MA10635100
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number25MA10635100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: