Provider Demographics
NPI:1831334747
Name:AJI, JAIME
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:AJI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 EVERETT PL
Mailing Address - Street 2:APT 6
Mailing Address - City:EAST RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07073-1705
Mailing Address - Country:US
Mailing Address - Phone:609-828-5458
Mailing Address - Fax:973-320-8381
Practice Address - Street 1:300 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-2734
Practice Address - Country:US
Practice Address - Phone:973-661-8995
Practice Address - Fax:973-320-8381
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-05
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT001378002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ22Other(RESPIRATORY, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS)