Healthcare Provider Details

I. General information

NPI: 1992017719
Provider Name (Legal Business Name): AYMAN KHAFAGI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2010
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 MEADOWLANDS PKWY
SECAUCUS NJ
07094-2977
US

IV. Provider business mailing address

55 MEADOWLANDS PKWY
SECAUCUS NJ
07094-2977
US

V. Phone/Fax

Practice location:
  • Phone: 201-392-3100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number25MA11901100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: