Provider Demographics
NPI:1215346218
Name:ADAM ALEX, LLC
Entity type:Organization
Organization Name:ADAM ALEX, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:GITTA
Authorized Official - Middle Name:S
Authorized Official - Last Name:VASHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-941-1555
Mailing Address - Street 1:725 RIVER RD
Mailing Address - Street 2:SUITE 27
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1171
Mailing Address - Country:US
Mailing Address - Phone:201-941-1555
Mailing Address - Fax:201-941-1556
Practice Address - Street 1:725 RIVER RD
Practice Address - Street 2:SUITE 27
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-1171
Practice Address - Country:US
Practice Address - Phone:201-941-1555
Practice Address - Fax:201-941-1556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty