Provider Demographics
NPI:1124295837
Name:V M AMIN MD PA
Entity type:Organization
Organization Name:V M AMIN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:V
Authorized Official - Middle Name:M
Authorized Official - Last Name:AMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-358-0611
Mailing Address - Street 1:333 OLD HOOK ROAD SUITE 105
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675
Mailing Address - Country:US
Mailing Address - Phone:201-358-0611
Mailing Address - Fax:201-722-0291
Practice Address - Street 1:333 OLD HOOK ROAD SUITE 105
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675
Practice Address - Country:US
Practice Address - Phone:201-358-0611
Practice Address - Fax:201-722-0291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02799600208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ125666Medicare PIN