Organization · NPI-2

165 Summit Internal Medicine Clinic PA

Clinic/Center, Primary Care · Hackensack, NJ

NPI number1558690446
StatusActive
Last updated in NPPESDec 23, 2009

Details

NPI
1558690446
Entity type
Organization (NPI-2)
Legal business name
165 Summit Internal Medicine Clinic PA
Organization subpart
No
Enumeration date
Dec 23, 2009
Last updated
Dec 23, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QP2300X Clinic/Center, Primary CareMA61265NJNJYes

Practice location

165 Summit Ave
Hackensack, NJ 07601-1311

Phone 201-488-5892 · Fax 201-488-0022

Mailing address

165 Summit Ave
Hackensack, NJ 07601-1311

Phone 201-488-5892 · Fax 201-488-0022

Authorized official

Aret Yegise Kahyaoglu
President
2014885892

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