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Individual

DR. AYMAN M IBRAHIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
194 BROAD ST, SUITE 4, BLOOMFIELD, NJ 07003-2606
(973) 680-8400
(973) 680-8404
Mailing address
370 W PLEASANTVIEW AVE, SUITE 2-299, HACKENSACK, NJ 07601-8004
(973) 680-8400
(973) 680-8404

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
02003764A
IN
2084N0400X
Neurology Physician
259590
NY
2084N0400X
Neurology Physician
Primary
25MB09396200
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0397261
NJ
01
M400050665
MEDICARE PTAN
IN
Enumeration date
06/02/2008
Last updated
11/08/2016
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