Healthcare Provider Details

I. General information

NPI: 1164335402
Provider Name (Legal Business Name): LINDA AYIM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 NORTHFIELD AVE
WEST ORANGE NJ
07052-3001
US

IV. Provider business mailing address

365 NORTHFIELD AVE
WEST ORANGE NJ
07052-3001
US

V. Phone/Fax

Practice location:
  • Phone: 201-673-6528
  • Fax:
Mailing address:
  • Phone: 201-673-6528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ15670300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: