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NPI Code Detail

MEDICARE: GOLD STANDARD MEDICAL GROUP PC.

MEDICARE: GOLD STANDARD MEDICAL GROUP PC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TA0400XAddiction (Substance Use Disorder) Psychologist
2261QM0850XAdult Mental Health Clinic/Center
3261QM0855XAdolescent and Children Mental Health Clinic/Center
4207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1043722853
Entity Type Code : Organization
Provider Name (Legal Business Name) : GOLD STANDARD MEDICAL GROUP PC.
Provider Business Mailing Address
First Line : 992 CLIFTON AVE
Second Line :
City : CLIFTON
State : NJ
Zip : 07013-3502
Country : US
Telephone Number : 862-249-1266
Fax Number : 862-249-1267
Provider Business Practice Location Address
First Line : 992 CLIFTON AVE
Second Line :
City : CLIFTON
State : NJ
Zip : 07013-3502
Country : US
Telephone Number : 862-249-1266
Fax Number : 862-249-1267
Authorized Official
Title or Position : OWNER
Name : DR. MUHAMMAD FARHAN IJAZ
Credential : MD
Telephone Number : 862-249-1266
Provider Enumeration Date : 11/02/2017
Last Update Date : 04/23/2024

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