Healthcare Provider Details

I. General information

NPI: 1013127299
Provider Name (Legal Business Name): AMER I ALADIN M.B.CH.B.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 HAMBURG TPKE STE 11
WAYNE NJ
07470-2063
US

IV. Provider business mailing address

516 HAMBURG TPKE STE 11
WAYNE NJ
07470-2063
US

V. Phone/Fax

Practice location:
  • Phone: 973-341-4623
  • Fax: 973-341-4624
Mailing address:
  • Phone: 973-341-4623
  • Fax: 973-341-4624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number2017-00462
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number25MA11853900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: