=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326231911
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GAMAL E GAD MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/27/2007
-----------------------------------------------------
Last Update Date | 12/28/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 541 E 29TH ST
-----------------------------------------------------
City | PATERSON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07504-1813
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-523-6830
-----------------------------------------------------
Fax | 973-523-3145
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 32 GREENWOOD AVE
-----------------------------------------------------
City | ELMWOOD PARK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07407-1718
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-523-6830
-----------------------------------------------------
Fax | 973-523-3145
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MS. NAHLA GAD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 973-979-2530
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------