Provider Demographics
NPI:1023083953
Name:ALAM, SYED FAHIM (MD)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:FAHIM
Last Name:ALAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 OVERLOOK RD
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE STATION
Mailing Address - State:NJ
Mailing Address - Zip Code:08889-3370
Mailing Address - Country:US
Mailing Address - Phone:908-575-7332
Mailing Address - Fax:908-575-7336
Practice Address - Street 1:107 E. MT. PLEASANT AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039
Practice Address - Country:US
Practice Address - Phone:973-535-3999
Practice Address - Fax:973-535-3222
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA079157002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0104663Medicaid
098011Medicare PIN
H07029Medicare UPIN