1437511219 NPI number — ALOBAIDI MD LLC NAWAR AL OBAIDI MD

Table of content: NAWAR AL OBAIDI MD (NPI 1437511219)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437511219 NPI number — ALOBAIDI MD LLC NAWAR AL OBAIDI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALOBAIDI MD LLC
Provider Last Name:
AL OBAIDI
Provider First Name:
NAWAR
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1437511219
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/25/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
707 Harmon Cove Tower
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
Secaucus
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07094
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
551-333-3686
Provider Business Mailing Address Fax Number:
877-214-2593

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
55 Meadowlands PKWY
Provider Second Line Business Practice Location Address:
3RD FL
Provider Business Practice Location Address City Name:
Secaucus
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07094
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
551-333-3686
Provider Business Practice Location Address Fax Number:
877-214-2593
Provider Enumeration Date:
03/22/2016

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: 207R00000X , with the licence number:  25MA10577100 , registered in the state of New Jersey ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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