Provider Demographics
NPI:1346286051
Name:AMIN, VISHNUBHAI M (MD FACS)
Entity Type:Individual
Prefix:DR
First Name:VISHNUBHAI
Middle Name:M
Last Name:AMIN
Suffix:
Gender:M
Credentials:MD FACS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:333 OLD HOOK ROAD SUITE 105
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675
Mailing Address - Country:US
Mailing Address - Phone:201-358-0611
Mailing Address - Fax:201-722-0291
Practice Address - Street 1:333 OLD HOOK ROAD SUITE 105
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675
Practice Address - Country:US
Practice Address - Phone:201-358-0611
Practice Address - Fax:201-722-0291
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02799600208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2791609Medicaid
NJ459183Medicare PIN
NJAM459183Medicare ID - Type Unspecified
NJ2791609Medicaid