Provider Demographics
NPI:1609997741
Name:AIMAN K SHILAD MD PROFESSIONAL ASSOC
Entity type:Organization
Organization Name:AIMAN K SHILAD MD PROFESSIONAL ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:AIMAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHILAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-909-1479
Mailing Address - Street 1:12 45 RIVER RD
Mailing Address - Street 2:117
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-0000
Mailing Address - Country:US
Mailing Address - Phone:973-209-0322
Mailing Address - Fax:888-215-7091
Practice Address - Street 1:680 BROADWAY
Practice Address - Street 2:STE 506 FIRST FLOOR
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514-1524
Practice Address - Country:US
Practice Address - Phone:973-209-0322
Practice Address - Fax:888-215-7091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========OtherTAX IDENTIFICATION NUMBER