Provider Demographics
NPI:1922622554
Name:ALKINDI MEDICAL
Entity Type:Organization
Organization Name:ALKINDI MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOUMA
Authorized Official - Middle Name:
Authorized Official - Last Name:JALOU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-342-4806
Mailing Address - Street 1:2208 QUEENSBURY WAY
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72908-9130
Mailing Address - Country:US
Mailing Address - Phone:973-342-4806
Mailing Address - Fax:
Practice Address - Street 1:872 PREAKNESS AVE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2804
Practice Address - Country:US
Practice Address - Phone:973-342-4806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-29
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service