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General NPI Number Information
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NPI Number | 1053332965
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Entity Type | Organization
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Legal Business Name | IMAD M ARIDI MD PA
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 76 W JIMMIE LEEDS RD 76 WEST PARK CENTRE SUITE 301
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City | GALLOWAY
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State | NJ
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Zip | 08205-9411
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Country | US
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Telephone | 609-652-9111
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Fax | 609-652-1283
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Provider Business Mailing Address
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Address Line | 76 W JIMMIE LEEDS RD 76 WEST PARK CENTRE SUITE 301
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City | GALLOWAY
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State | NJ
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Zip | 08205-9411
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Country | US
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Telephone | 609-652-9111
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Fax | 609-652-1283
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Authorized Official
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Title or Position | OWNER
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Name | IMAD ARIDI
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Credential | M.D.
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Telephone | 609-652-9111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA04727700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 25MA04727700
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 25MA04727700
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA04727700
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License Number State | NJ
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