1992750715 NPI number — AIMAN K SHILAD M.D.

Table of content: AIMAN K SHILAD M.D. (NPI 1992750715)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992750715 NPI number — AIMAN K SHILAD M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHILAD
Provider First Name:
AIMAN
Provider Middle Name:
K
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1992750715
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/12/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12-45 RIVER RD
Provider Second Line Business Mailing Address:
STE 117
Provider Business Mailing Address City Name:
FAIR LAWN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07410-1812
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-209-0322
Provider Business Mailing Address Fax Number:
888-215-7091

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
680 BROADWAY
Provider Second Line Business Practice Location Address:
STE 506 FIRST FLOOR
Provider Business Practice Location Address City Name:
PATERSON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07514-1524
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-500-2399
Provider Business Practice Location Address Fax Number:
855-302-5570
Provider Enumeration Date:
05/23/2006

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: 207V00000X , with the licence number:  25MA07788200 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1356533624 . This is a "GRP NPI SURGAIDE 2, LLC" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 00010768801 . This is a "AMERICHOICE MEDICAID HMO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 00010768806 . This is a "AMERICHOICE MEDICAID HMO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 00010768800 . This is a "AMERICHOICE MEDICAID HMO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1790731271 . This is a "GRP NPI COMPREHENSIVE WOMEN'S HEALTHCARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1790910917 . This is a "GRP NPI ADVANCED LAPAROSCOPY, LLC" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 191465 . This is a "AMERIGROUP MEDICAID HMO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1942321070 . This is a "GRP NPI SURGAIDE 1, LLC" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 00010768803 . This is a "AMERICHOICE MEDICAID HMO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 00010768802 . This is a "AMERICHOICE MEDICAID HMO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 00010768807 . This is a "AMERICHOICE MEDICAID HMO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0091626 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00010768805 . This is a "AMERICHOICE MEDICAID HMO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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