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General NPI Number Information
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NPI Number | 1720633969
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Entity Type | Organization
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Legal Business Name | VISITING DOCTORS ASSOCIATES
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Dates
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Enumeration Date | 08/05/2019
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 3807 BERGENLINE AVE
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City | UNION CITY
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State | NJ
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Zip | 07087-4860
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Country | US
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Telephone | 201-582-3000
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Fax | 201-489-7800
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Provider Business Mailing Address
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Address Line | 3807 BERGENLINE AVE
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City | UNION CITY
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State | NJ
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Zip | 07087-4860
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Country | US
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Telephone | 201-582-3000
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Fax | 201-489-7800
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Authorized Official
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Title or Position | OWNER
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Name | IDIR SARADOUNI
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Credential |
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Telephone | 201-691-4828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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