Healthcare Provider Details

I. General information

NPI: 1689834491
Provider Name (Legal Business Name): BERGEN ESSEX INFECTIOUS DISEASES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2008
Last Update Date: 10/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 PASCACK RD
PARAMUS NJ
07652-4235
US

IV. Provider business mailing address

716 PASCACK RD
PARAMUS NJ
07652-4235
US

V. Phone/Fax

Practice location:
  • Phone: 201-261-4838
  • Fax:
Mailing address:
  • Phone: 120-126-1483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number25MA06586700
License Number StateNJ

VIII. Authorized Official

Name: DR. ARIFF ADMANI
Title or Position: OWNER
Credential: M. D.
Phone: 12012614838