Healthcare Provider Details

I. General information

NPI: 1902719685
Provider Name (Legal Business Name): ADAM S CHOICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 WALL ST W APT 5212
LYNDHURST NJ
07071-3540
US

IV. Provider business mailing address

1301 WALL ST W APT 5212
LYNDHURST NJ
07071-3540
US

V. Phone/Fax

Practice location:
  • Phone: 201-682-5225
  • Fax:
Mailing address:
  • Phone: 201-682-5225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: MARIAM ELBEDEIWY
Title or Position: CLINICAL DIRECTOR
Credential: LPC
Phone: 201-682-5225