1518977172 NPI number — NAIM T. NAZHA MD PC

Table of content: (NPI 1518977172)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518977172 NPI number — NAIM T. NAZHA MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NAIM T. NAZHA MD PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518977172
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/16/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
411 NEW RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTHFIELD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08225-1648
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-383-6033
Provider Business Mailing Address Fax Number:
609-383-0064

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
411 NEW RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTHFIELD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08225-1648
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-383-6033
Provider Business Practice Location Address Fax Number:
609-383-0064
Provider Enumeration Date:
08/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NAZHA
Authorized Official First Name:
NAIM
Authorized Official Middle Name:
T.
Authorized Official Title or Position:
PRESIDENT / CEO
Authorized Official Telephone Number:
609-383-6033

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  25MA04569800 , 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)

  • Identifier: 0057805 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P515578 . This is a "OXFORD NAZHA MD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0013749 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001611701 . This is a "AMERIHEALTH SM" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2289062000 . This is a "AMERIHEALTH HMO PPO POS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 563232 . This is a "HORIZON" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: Q11701 . This is a "AMERIHEALTH ADMINISTRATOR" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: FO8129 . This is a "HEALTHNET - NAZHA MD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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