Provider Demographics
NPI:1255600094
Name:POLYMATH MEDICAL, LLC
Entity type:Organization
Organization Name:POLYMATH MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ISLAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ELFAYOUMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-986-4965
Mailing Address - Street 1:128 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE FERRY
Mailing Address - State:NJ
Mailing Address - Zip Code:07643-1023
Mailing Address - Country:US
Mailing Address - Phone:973-365-4830
Mailing Address - Fax:
Practice Address - Street 1:350 BOULEVARD
Practice Address - Street 2:ST. MARY'S HOSPITAL
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055
Practice Address - Country:US
Practice Address - Phone:973-365-4830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-23
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty