Provider Demographics
NPI:1639336035
Name:SILVER INVALID COACH
Entity Type:Organization
Organization Name:SILVER INVALID COACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FAREED
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDULATIF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-763-0122
Mailing Address - Street 1:10 N RIDGEWOOD RD # 215
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079
Mailing Address - Country:US
Mailing Address - Phone:973-763-0122
Mailing Address - Fax:
Practice Address - Street 1:10 N RIDGEWOOD RD APT 215
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-1553
Practice Address - Country:US
Practice Address - Phone:973-763-0122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ6588506343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)