Provider Demographics
NPI:1770826141
Name:NEW JERSEY HYPERTENSION AND KIDNEY CARE LLC
Entity Type:Organization
Organization Name:NEW JERSEY HYPERTENSION AND KIDNEY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:NABEEL
Authorized Official - Middle Name:
Authorized Official - Last Name:IMAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-766-1830
Mailing Address - Street 1:115 TIMBER RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-3018
Mailing Address - Country:US
Mailing Address - Phone:513-766-1830
Mailing Address - Fax:
Practice Address - Street 1:1235 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3810
Practice Address - Country:US
Practice Address - Phone:609-587-3003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09079200207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty