Healthcare Provider Details

I. General information

NPI: 1548215411
Provider Name (Legal Business Name): AMANA MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 06/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

871 MCBRIDE AVE
WEST PATERSON NJ
07424-2745
US

IV. Provider business mailing address

871 MCBRIDE AVE
WEST PATERSON NJ
07424-2745
US

V. Phone/Fax

Practice location:
  • Phone: 973-569-4488
  • Fax:
Mailing address:
  • Phone: 973-569-4488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMA062346
License Number StateNJ

VIII. Authorized Official

Name: DR. YOUSEF ZIBDIE
Title or Position: OWNER
Credential: MD
Phone: 973-569-4488