Healthcare Provider Details

I. General information

NPI: 1720161680
Provider Name (Legal Business Name): ALMA C UMALI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 PENNINGTON AVE
PASSAIC NJ
07055-4617
US

IV. Provider business mailing address

149 GLADSTONE DR
PARSIPPANY NJ
07054-3419
US

V. Phone/Fax

Practice location:
  • Phone: 973-470-3000
  • Fax: 973-470-3506
Mailing address:
  • Phone: 973-402-8754
  • Fax: 973-470-3506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number25MA02688800
License Number StateNJ

VII. Legacy identifiers

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

# 1
Identifier3719804
Identifier TypeMEDICAID
Identifier StateNJ
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: