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General NPI Number Information
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NPI Number | 1932972676
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Entity Type | Organization
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Legal Business Name | WAHAB MEDICAL
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Dates
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Enumeration Date | 11/03/2023
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 2775 JOHN F KENNEDY BLVD
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City | JERSEY CITY
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State | NJ
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Zip | 07306-5515
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Country | US
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Telephone | 201-328-4391
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Fax |
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Provider Business Mailing Address
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Address Line | 106 OSPREY CT
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City | SECAUCUS
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State | NJ
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Zip | 07094-2936
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AYMAN ABDELWAHAB
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Credential |
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Telephone | 201-328-4391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number |
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License Number State |
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