Healthcare Provider Details

I. General information

NPI: 1023927043
Provider Name (Legal Business Name): ADEEL MALIK
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 BROADWAY
UNION CITY NJ
07087-6516
US

IV. Provider business mailing address

435 79TH ST
NORTH BERGEN NJ
07047-5541
US

V. Phone/Fax

Practice location:
  • Phone: 201-751-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number40QB00431500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: