Provider Demographics
NPI:1225475247
Name:PYRAMIDS CLINIC
Entity Type:Organization
Organization Name:PYRAMIDS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BADAWY
Authorized Official - Middle Name:
Authorized Official - Last Name:BADAWY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-985-9000
Mailing Address - Street 1:2738 KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-5508
Mailing Address - Country:US
Mailing Address - Phone:201-985-9000
Mailing Address - Fax:
Practice Address - Street 1:2738 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-5508
Practice Address - Country:US
Practice Address - Phone:201-985-9000
Practice Address - Fax:201-938-0666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04430700261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
1760582373OtherNPI NUMBER