Healthcare Provider Details

I. General information

NPI: 1871559005
Provider Name (Legal Business Name): JEFFREY SAMUEL KAIDEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 11/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 FAIRVIEW AVENUE
WESTWOOD NJ
07675
US

IV. Provider business mailing address

PO BOX 698 300 FAIRVIEW AVENUE
WESTWOOD NJ
07675
US

V. Phone/Fax

Practice location:
  • Phone: 201-666-4014
  • Fax: 201-666-4754
Mailing address:
  • Phone: 201-666-4014
  • Fax: 201-666-4754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number25MA03386500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: