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General NPI Number Information
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NPI Number | 1588946610
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Entity Type | Organization
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Legal Business Name | SILVER INVALID COACH
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Dates
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Enumeration Date | 09/14/2011
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Last Update Date | 09/14/2011
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Provider Practice Location Address
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Address Line | 10 N RIDGEWOOD RD SUITE 215
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City | SOUTH ORANGE
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State | NJ
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Zip | 07079-1555
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Country | US
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Telephone | 973-821-5446
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Fax | 973-676-2208
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Provider Business Mailing Address
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Address Line | 10 N RIDGEWOOD RD SUITE 215
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City | SOUTH ORANGE
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State | NJ
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Zip | 07079-1555
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Country | US
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Telephone | 973-821-5446
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Fax | 973-676-2208
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Authorized Official
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Title or Position | OWNER
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Name | MR. FREED ABDULATIF
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Credential |
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Telephone | 973-821-5446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 6588506
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License Number State | NJ
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