NPIMap

Organization Active NPI

West Paterson Specialty Clinic Inc

  • Infectious Disease Physician
  • Woodland Park, NJ
National Provider Identifier
1730135682
Registry record updated Mar 14, 2011
On this page

Key facts

NPPES NPI Registry
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
Last updated
Mar 14, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2011

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

Authorized official

Name
Dr. Mohammad S Ibrahim, MDNPI 1265494645
Title
Owner
Phone
(973) 569-4488

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X MA61942 NJ Primary

Addresses

Primary practice location

871 McBride Ave
Woodland Park, NJ 07424-2748

Mailing address

871 McBride Ave
Woodland Park, NJ 07424-2748
Phone (973) 569-4488

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Park, NJ

Sources for this page

  • 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.