| West Paterson Specialty Clinic Inc | |
|
871 Mcbride Ave Woodland Park NJ 07424-2748 | |
| (973) 569-4488 | |
| (973) 569-4743 |
| Full Name | West Paterson Specialty Clinic Inc |
|---|---|
| Speciality | Internal Medicine - Infectious Disease |
| Location | 871 Mcbride Ave, Woodland Park, New Jersey |
| Authorized Official Name and Position | Mohammad S Ibrahim (OWNER) |
| Authorized Official Contact | 9735694488 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| West Paterson Specialty Clinic Inc 871 Mcbride Ave Woodland Park NJ 07424-2748 Ph: (973) 569-4488 | West Paterson Specialty Clinic Inc 871 Mcbride Ave Woodland Park NJ 07424-2748 Ph: (973) 569-4488 |
| NPI Number | 1730135682 |
|---|---|
| Provider Enumeration Date | 05/25/2006 |
| Last Update Date | 03/14/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730135682 | NPI | - | NPPES |
| 8549401 | Medicaid | NJ | |
| 8472505 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | MA61942 (New Jersey) | Primary |
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