Healthcare Provider Details

I. General information

NPI: 1649858663
Provider Name (Legal Business Name): TAREK ALMALEH DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 E RIDGEWOOD AVE
RIDGEWOOD NJ
07450-3815
US

IV. Provider business mailing address

143 E RIDGEWOOD AVE STE 1147
RIDGEWOOD NJ
07450-3815
US

V. Phone/Fax

Practice location:
  • Phone: 551-222-0048
  • Fax:
Mailing address:
  • Phone: 551-222-0048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number25MB13206100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: