Healthcare Provider Details

I. General information

NPI: 1811449911
Provider Name (Legal Business Name): AIM MEDICAL CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2016
Last Update Date: 10/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 RIVERDALE RD SUITE 1
RIVERDALE NJ
07457-1703
US

IV. Provider business mailing address

90 RIVERDALE RD SUITE 1
RIVERDALE NJ
07457-1703
US

V. Phone/Fax

Practice location:
  • Phone: 813-541-6131
  • Fax:
Mailing address:
  • Phone: 813-541-6131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number26NJ00592200
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number25MA08838800
License Number StateNJ

VIII. Authorized Official

Name: VAL JONUZI
Title or Position: MEDICAL BILLER
Credential:
Phone: 609-641-9009