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General NPI Number Information
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NPI Number | 1003429036
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Entity Type | Organization
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Legal Business Name | ONE OAK MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 08/28/2020
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Last Update Date | 09/17/2020
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Provider Practice Location Address
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Address Line | 1200 GREEN ST
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City | ISELIN
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State | NJ
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Zip | 08830-2014
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Country | US
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Telephone | 973-870-0777
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Fax |
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Provider Business Mailing Address
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Address Line | 342 HAMBURG TPKE
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City | WAYNE
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State | NJ
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Zip | 07470-2162
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Country | US
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Telephone | 973-870-0777
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Fax |
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Authorized Official
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Title or Position | MD/OWNER
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Name | FAISAL MAHMOOD
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Credential | MD
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Telephone | 973-870-0777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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