Avicenna Medical Group, Llc

LBN: Avicenna Medical Group, Llc
Avicenna Medical Group, Llc is an health care organization with primary practice located at 414 Eagle Rock Ave Suite 307, West Orange NJ 07052-4224. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as the primary health care specialty. Avicenna Medical Group, Llc can be contacted via phone (646) 464-3110, or through Samaan, Fadi via phone (646) 464-3110.

Contact Information

Primary practice address
414 Eagle Rock Ave Suite 307 West Orange NJ 07052-4224
Phone: (646) 464-3110
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Samaan, Fadi MBA, MS
Phone: (646) 464-3110

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 25MB07627000 New Jersey

Profile Details

NPI number 1194067959
LBN Legal business name Avicenna Medical Group, Llc
DBA Doing business as
Authorized official Samaan, Fadi MBA, MS
Entity Organization
Organization subpart 1 No
Enumeration date Mar 20th, 2013
Last updated Mar 22nd, 2013 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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