1205886710 NPI number — AYDA M. EL-SHIRBINY

Table of content: AYDA M. EL-SHIRBINY (NPI 1205886710)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205886710 NPI number — AYDA M. EL-SHIRBINY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EL-SHIRBINY
Provider First Name:
AYDA
Provider Middle Name:
M.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205886710
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
NEW JERSEY INSTITUTE OF RADIOLOGY
Provider Second Line Business Mailing Address:
630 BROAD STREET
Provider Business Mailing Address City Name:
CARLSTADT
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07072-0468
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-372-1020
Provider Business Mailing Address Fax Number:
201-372-1028

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
NEW JERSEY INSTITUTE OF RADIOLOGY
Provider Second Line Business Practice Location Address:
630 BROAD STREET
Provider Business Practice Location Address City Name:
CARLSTADT
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07072-0468
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-372-1020
Provider Business Practice Location Address Fax Number:
201-372-1028
Provider Enumeration Date:
05/12/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207U00000X , with the licence number:  25MA07977800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 207UN0901X , with the licence number: 25MA07977800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 207UN0902X , with the licence number: 25MA07977800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 207UN0903X , with the licence number: 25MA07977800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 2085N0904X , with the licence number: 25MA07977800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)