Provider Demographics
NPI:1740397181
Name:ALAM, PARVEZ (MD)
Entity type:Individual
Prefix:
First Name:PARVEZ
Middle Name:
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 1:395 DANFORTH AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-1975
Mailing Address - Country:US
Mailing Address - Phone:201-332-4600
Mailing Address - Fax:201-332-4670
Practice Address - Street 1:395 DANFORTH AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305
Practice Address - Country:US
Practice Address - Phone:201-332-4600
Practice Address - Fax:201-332-4670
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06755300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00654768OtherRAILROAD MEDICARE
NJ7807406Medicaid
NJ7807406Medicaid
NJ032310UXWMedicare PIN
NJ032310TM8Medicare PIN
NJP00654768OtherRAILROAD MEDICARE
NJ164895TM8Medicare PIN
NJ21967OtherUHP-NON PAR #
NJ032310Medicare ID - Type Unspecified
NJ032310SNYMedicare PIN