1487432878 NPI number — MRS. TASWIYAH RA'OOF-SALEEM NURSE PRACTITIONER

Table of content: MRS. TASWIYAH RA'OOF-SALEEM NURSE PRACTITIONER (NPI 1487432878)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487432878 NPI number — MRS. TASWIYAH RA'OOF-SALEEM NURSE PRACTITIONER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RA'OOF-SALEEM
Provider First Name:
TASWIYAH
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
NURSE PRACTITIONER
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RAOOF
Provider Other First Name:
TASWIYAH
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
NURSE PRACTITIONER
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1487432878
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/08/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
50A NEWARK WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAPLEWOOD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07040-3310
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-885-0475
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
935 GARFIELD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JERSEY CITY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07304-2731
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-478-5800
Provider Business Practice Location Address Fax Number:
201-478-5814
Provider Enumeration Date:
09/18/2023

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LG0600X , with the licence number:  26NJ14844500 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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