Provider Demographics
NPI:1588310650
Name:ALDAD MEDICAL PC
Entity type:Organization
Organization Name:ALDAD MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALDAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-505-7200
Mailing Address - Street 1:510 HEMPSTEAD TPKE RM 203
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-1152
Mailing Address - Country:US
Mailing Address - Phone:516-505-7200
Mailing Address - Fax:
Practice Address - Street 1:100 CAMBRIDGE ST FL 14
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2509
Practice Address - Country:US
Practice Address - Phone:516-505-7200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-26
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA290915OtherLICENSE