Organization
AHKAMI MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAHROKH STANCHAK M.D. (CREDENTIALING COORDINATOR)
(974) 471-9585
Entity
Organization
Contact information
Practice address
110 PASSAIC AVE, PASSAIC, NJ 07055-4827
(973) 471-9585
(973) 471-8534
Mailing address
110 PASSAIC AVE, PASSAIC, NJ 07055-4827
(973) 471-9585
(973) 471-8534
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
04/06/2007
Last updated
12/18/2009
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