Provider Demographics
NPI:1043240823
Name:AMIN, ANILA (MD)
Entity Type:Individual
Prefix:
First Name:ANILA
Middle Name:
Last Name:AMIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 NEW RD
Mailing Address - Street 2:CENTRAL PARK EAST, #101
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1299
Mailing Address - Country:US
Mailing Address - Phone:609-927-7070
Mailing Address - Fax:906-927-7105
Practice Address - Street 1:222 NEW RD
Practice Address - Street 2:CENTRAL PARK EAST, #101
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1299
Practice Address - Country:US
Practice Address - Phone:609-927-7070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA44828207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF13434Medicare UPIN
057071Medicare ID - Type Unspecified