Provider Demographics
NPI:1619266301
Name:IDEAL FIRST ASSISTANTS LLC
Entity Type:Organization
Organization Name:IDEAL FIRST ASSISTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ENAMUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HOQUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-653-8920
Mailing Address - Street 1:174 MAPES AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07112-2018
Mailing Address - Country:US
Mailing Address - Phone:347-653-8920
Mailing Address - Fax:
Practice Address - Street 1:174 MAPES AVE FL 3
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-2018
Practice Address - Country:US
Practice Address - Phone:347-653-8920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
NJ25MP00145100363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty