Healthcare Provider Details

I. General information

NPI: 1427398536
Provider Name (Legal Business Name): AELIA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2013
Last Update Date: 02/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 GREGORY RD
PARAMUS NJ
07652-2117
US

IV. Provider business mailing address

405 GREGORY RD
PARAMUS NJ
07652-2117
US

V. Phone/Fax

Practice location:
  • Phone: 845-558-0200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: BDAIR ABULAIMOUN
Title or Position: OWNER
Credential: M.D.
Phone: 845-558-0200