Provider Demographics
NPI:1447586284
Name:J. SLIM, LLC
Entity Type:Organization
Organization Name:J. SLIM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JIHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SLIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-597-0704
Mailing Address - Street 1:PO BOX 8179
Mailing Address - Street 2:
Mailing Address - City:GLEN RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07028-8179
Mailing Address - Country:US
Mailing Address - Phone:239-597-0704
Mailing Address - Fax:239-597-0709
Practice Address - Street 1:111 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-1909
Practice Address - Country:US
Practice Address - Phone:239-597-0704
Practice Address - Fax:239-597-0709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-29
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04504500207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0225746Medicaid
NJ1015508Medicaid
NJ556993Medicare PIN