Provider Demographics
NPI:1679893861
Name:ONCOLOGY ASSOCIATES OF NORTH JERSEY LIMITED LIABILITY COMPANY
Entity type:Organization
Organization Name:ONCOLOGY ASSOCIATES OF NORTH JERSEY LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:IMTIAZ
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-528-1388
Mailing Address - Street 1:361 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-1664
Mailing Address - Country:US
Mailing Address - Phone:516-528-1388
Mailing Address - Fax:973-667-3002
Practice Address - Street 1:361 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-1664
Practice Address - Country:US
Practice Address - Phone:516-528-1388
Practice Address - Fax:973-667-3002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08749900207RH0003X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty