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General NPI Number Information
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NPI Number | 1770826141
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Entity Type | Organization
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Legal Business Name | NEW JERSEY HYPERTENSION AND KIDNEY CARE LLC
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Dates
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Enumeration Date | 04/03/2013
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Last Update Date | 04/03/2013
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Provider Practice Location Address
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Address Line | 1235 WHITEHORSE MERCERVILLE RD
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City | HAMILTON
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State | NJ
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Zip | 08619-3810
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Country | US
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Telephone | 609-587-3003
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Fax |
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Provider Business Mailing Address
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Address Line | 115 TIMBER RIDGE CT
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City | NEPTUNE
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State | NJ
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Zip | 07753-3018
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Country | US
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Telephone | 513-766-1830
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Fax |
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Authorized Official
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Title or Position | MD
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Name | NABEEL IMAM
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Credential |
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Telephone | 513-766-1830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 25MA09079200
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License Number State | NJ
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