Healthcare Provider Details

I. General information

NPI: 1669117479
Provider Name (Legal Business Name): AL OBAIDI MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2022
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 W RIDGEWOOD AVE # 2
PARAMUS NJ
07652-2333
US

IV. Provider business mailing address

PO BOX 336
RAMSEY NJ
07446-0336
US

V. Phone/Fax

Practice location:
  • Phone: 551-333-3686
  • Fax: 877-214-2593
Mailing address:
  • Phone: 513-333-3686
  • Fax: 877-214-2593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: NAWAR FALIH AL OBAIDI
Title or Position: CEO
Credential: MD
Phone: 551-333-3686