Provider Demographics
NPI:1932141256
Name:MDSLIM, LLC
Entity Type:Organization
Organization Name:MDSLIM, LLC
Other - Org Name:INSTITUTE FOR WEIGHT MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANJANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHHABRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-487-8010
Mailing Address - Street 1:150 OVERLOOK AVENUE
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-2206
Mailing Address - Country:US
Mailing Address - Phone:201-487-8010
Mailing Address - Fax:201-487-7010
Practice Address - Street 1:150 OVERLOOK AVENUE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-2206
Practice Address - Country:US
Practice Address - Phone:201-487-8010
Practice Address - Fax:201-487-7010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ101580OtherMEDICARE PROVIDER NUMBER