Provider Demographics
NPI:1396266680
Name:TULIP OBGYN LLC
Entity type:Organization
Organization Name:TULIP OBGYN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:M
Authorized Official - Last Name:ALNAKEEB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-807-2727
Mailing Address - Street 1:PO BOX 2335
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07015-2335
Mailing Address - Country:US
Mailing Address - Phone:973-807-2727
Mailing Address - Fax:973-807-1931
Practice Address - Street 1:991 MAIN ST STE 2B
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07503
Practice Address - Country:US
Practice Address - Phone:973-807-2727
Practice Address - Fax:973-807-1931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-28
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0563374Medicaid