Provider Demographics
NPI:1184009748
Name:AFFINITY HEALTHCARE GROUP RIDGEFIELD LLC
Entity Type:Organization
Organization Name:AFFINITY HEALTHCARE GROUP RIDGEFIELD LLC
Other - Org Name:AFFINITY HEALTHCARE GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAGDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHMOUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-650-2009
Mailing Address - Street 1:195 US HIGHWAY 46
Mailing Address - Street 2:SUITE 4
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512-1824
Mailing Address - Country:US
Mailing Address - Phone:973-650-2009
Mailing Address - Fax:253-650-2009
Practice Address - Street 1:195 US HIGHWAY 46
Practice Address - Street 2:SUITE 4
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-1824
Practice Address - Country:US
Practice Address - Phone:973-650-2009
Practice Address - Fax:253-650-2009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-24
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8234400Medicaid
NJ037602Medicare Oscar/Certification