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Abdurrahman Abdulhakeem

Individual provider Active NPI Basic Emergency Medical Technician · East Orange, NJ

NPI 1477940872 · NPPES record last updated Apr 25, 2015

Key facts

NPI
1477940872
Entity type
Individual (NPI type 1)
Primary specialty
Basic Emergency Medical Technician 146N00000X
License
102777 (NJ)
Practice address
492 Park Ave
Apt2
East Orange, NJ 07017-2590
Phone
(862) 252-0858
Fax
(862) 252-8808
NPI assigned
Apr 23, 2015
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
102777NJMDBasic Emergency Medical Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Standard Care Medical Transportation LLC Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X 102777 NJ Yes

Addresses

Primary practice location

492 Park Ave
Apt2
East Orange, NJ 07017-2590

Mailing address

492 Park Ave
Apt2
East Orange, NJ 07017-2590
Phone (862) 252-0858

Other providers in East Orange, NJ

All providers in East Orange, NJ · Basic Emergency Medical Technician in New Jersey

Sources for this page

Verify at the official NPI Registry.