Provider Demographics
NPI:1376953851
Name:BAYTUL- IMAN, INC
Entity Type:Organization
Organization Name:BAYTUL- IMAN, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR BUSINESS DEVELOPMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WAHID
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIBLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-207-5893
Mailing Address - Street 1:428 MORRISTOWN RD
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-3586
Mailing Address - Country:US
Mailing Address - Phone:732-207-5893
Mailing Address - Fax:
Practice Address - Street 1:311 LAUREL AVE
Practice Address - Street 2:
Practice Address - City:HAZLET TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07734-3023
Practice Address - Country:US
Practice Address - Phone:732-207-5893
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-05
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care