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Organization

IBRAHIM WILLIAM SIDHOM M.D.,P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
IBRAHIM WILLIAM SIDHOM M.D. (PRESIDENT)
(732) 541-5595
Entity
Organization

Contact information

Practice address
48 PULASKI AVE, CARTERET, NJ 07008-2509
(732) 541-5595
Mailing address
48 PULASKI AVE, CARTERET, NJ 07008-2509
(732) 541-5595

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
MA50525
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7530803
NJ
Enumeration date
05/06/2008
Last updated
05/06/2008
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