Basic Information
| Provider Information | |||||||||
| NPI: | 1659326833 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AMIN | ||||||||
| FirstName: | NAEEM | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 FEDERAL ST # 200 | ||||||||
| Address2: | |||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081031088 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563564924 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 COOPER PLZ | ||||||||
| Address2: | |||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081031461 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563422000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2006 | ||||||||
| LastUpdateDate: | 03/05/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | 25MA07939800 | NJ | N | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 208M00000X | 25MA07939800 | NJ | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 074021 | 05 | NJ | MEDICAID | 243435 | 01 | AMERIGROUP/AMERICAID | OTHER | 7432737 | 01 | AETNA/US HEALTHCARE | OTHER | 2K9848 | 01 | HEALTHNET | OTHER | P00826075 | 01 | RAILROAD MEDICARE-PALMETTO | OTHER | 0074021 | 05 | NJ | MEDICAID | 01077795500 | 01 | AMERICHOICE | OTHER | 45177 | 01 | NJ | UNIVERSITY HEALTH PLAN | OTHER | 60016567 | 01 | HORIZON | OTHER | 60016567 | 01 | NJ | HORIZON NJ HEALTH | OTHER | P3629766 | 01 | OXFORD | OTHER |