Provider Demographics
NPI:1841227121
Name:ALLIED MEDICAL AND DIAGNOSTIC SERVICES LLC
Entity Type:Organization
Organization Name:ALLIED MEDICAL AND DIAGNOSTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:ASAD
Authorized Official - Last Name:MIRZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-493-7607
Mailing Address - Street 1:124 EILEEN DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07009-1352
Mailing Address - Country:US
Mailing Address - Phone:973-493-7607
Mailing Address - Fax:973-471-1202
Practice Address - Street 1:124 EILEEN DR
Practice Address - Street 2:
Practice Address - City:CEDAR GROVE
Practice Address - State:NJ
Practice Address - Zip Code:07009-1352
Practice Address - Country:US
Practice Address - Phone:973-493-7607
Practice Address - Fax:973-471-1202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA072674207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH47758Medicare UPIN
NJ102875Medicare PIN