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General NPI Number Information
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NPI Number | 1912269978
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Entity Type | Individual
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Provider Name | ATEF ABOULFATEH MD
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Gender | Male
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Dates
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Enumeration Date | 06/14/2012
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Last Update Date | 06/14/2012
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Provider Practice Location Address
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Address Line | 203 N16TH ST 2ND FL
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City | BLOOMFIELD
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State | NJ
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Zip | 07003
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Country | US
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Telephone | 973-429-2465
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Fax |
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Provider Business Mailing Address
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Address Line | 203 N 16TH ST 2ND FLOOR
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City | BLOOMFIELD
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State | NJ
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Zip | 07003-5951
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Country | US
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Telephone | 973-429-2465
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP0904X
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Taxonomy Name | Federal Public Health Clinic/Center
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License Number |
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License Number State |
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