1831334747 NPI number — JAIME AJI

Table of content: JAIME AJI (NPI 1831334747)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831334747 NPI number — JAIME AJI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AJI
Provider First Name:
JAIME
Provider Middle Name:
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:
1831334747
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/17/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
204 EVERETT PL
Provider Second Line Business Mailing Address:
APT 6
Provider Business Mailing Address City Name:
EAST RUTHERFORD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07073-1705
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-828-5458
Provider Business Mailing Address Fax Number:
973-320-8381

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 FRANKLIN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NUTLEY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07110-2734
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-661-8995
Provider Business Practice Location Address Fax Number:
973-320-8381
Provider Enumeration Date:
12/05/2008

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: 2255A2300X , with the licence number:  25MT00137800 , 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: 22 . This is a "(RESPIRATORY, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS)" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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