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NPI 1366128282

NPI 1366128282 : INSTANT MD LLC : NORTH BERGEN, NJ

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General NPI Number Information
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    NPI Number           |    1366128282
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    Entity Type          |    Organization 
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    Legal Business Name  |    INSTANT MD LLC 
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Dates
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    Enumeration Date     |    06/26/2023
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    Last Update Date     |    01/21/2025
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Provider Practice Location Address
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    Address Line         |    7511 BERGENLINE AVE STE 101 
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    City                 |    NORTH BERGEN
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    State                |    NJ
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    Zip                  |    07047-5459
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    Country              |    US
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    Telephone            |    201-378-3608
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7511 BERGENLINE AVE STE 101 
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    City                 |    NORTH BERGEN
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    State                |    NJ
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    Zip                  |    07047-5459
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    Country              |    US
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    Telephone            |    201-378-3608
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OFFICER
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    Name                 |    MR. HUSAM  WADI 
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    Credential           |    
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    Telephone            |    201-378-3608
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QM0801X
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    Taxonomy Name        |    Mental Health Clinic/Center (Including Community Mental Health Center)
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    261QM0850X
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    Taxonomy Name        |    Adult Mental Health Clinic/Center
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    261QM0855X
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    Taxonomy Name        |    Adolescent and Children Mental Health Clinic/Center
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    License Number       |    
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    License Number State |    
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