West Paterson Specialty Clinic Inc

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

MA61942 Issued in NJ

Legal business name

WEST PATERSON SPECIALTY CLINIC INC

Practice address

871 McBride Ave
Woodland Park, NJ 07424-2748

Phone

(973) 569-4488

Fax

(973) 569-4743

NPI assigned

May 25, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mohammad S Ibrahim, MD

Title

Owner

Phone

(973) 569-4488

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300060800000",
    "number": "1730135682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "871 MCBRIDE AVE",
            "city": "WOODLAND PARK",
            "state": "NJ",
            "postal_code": "074242748",
            "telephone_number": "973-569-4488",
            "fax_number": "973-569-4743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 MCBRIDE AVE",
            "city": "WOODLAND PARK",
            "state": "NJ",
            "postal_code": "074242748",
            "telephone_number": "973-569-4488",
            "fax_number": "973-569-4743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST PATERSON SPECIALTY CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2011-03-14",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-569-4488",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NJ",
            "license": "MA61942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8549401",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8472505",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Saad Waqas
• Debbie Ward
• Todd B Wassmer, DC
• West Paterson First Aid Squad
• Ramone Wilson
• Woodland Park Board of Education
• Woodland Park Dental Centers
• Woodland Park Dentistry, LLC
• Woodland Park Dialysis Center LLC

• Infectious Disease Physician in Woodland Park, NJ
• Providers in Woodland Park, NJ by specialty
• Infectious Disease Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.