Provider Demographics
NPI:1811449911
Name:AIM MEDICAL CENTERS LLC
Entity type:Organization
Organization Name:AIM MEDICAL CENTERS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:
Authorized Official - First Name:VAL
Authorized Official - Middle Name:
Authorized Official - Last Name:JONUZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-641-9009
Mailing Address - Street 1:90 RIVERDALE RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:RIVERDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07457-1703
Mailing Address - Country:US
Mailing Address - Phone:813-541-6131
Mailing Address - Fax:
Practice Address - Street 1:90 RIVERDALE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:RIVERDALE
Practice Address - State:NJ
Practice Address - Zip Code:07457-1703
Practice Address - Country:US
Practice Address - Phone:813-541-6131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X, 175F00000X
NJ26NJ00592200363LP2300X
NJ25MA08838800133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, MetabolicGroup - Single Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Single Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty