Basic Information
| Provider Information | |||||||||
| NPI: | 1073683033 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AWAD | ||||||||
| FirstName: | AIDA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | GPO BOX 27097 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100877097 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182838773 | ||||||||
| FaxNumber: | 7182838796 | ||||||||
| Practice Location | |||||||||
| Address1: | 17 7TH ST | ||||||||
| Address2: | RIDGEFIELD PARK | ||||||||
| City: | RIDGEFIELD PARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076601014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2016411747 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2006 | ||||||||
| LastUpdateDate: | 01/29/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 241482 | NY | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.