1629826987 NPI number — MISS JUMANA AMJAD ZAKARIA AL SEIDI M.D

Table of content: MISS JUMANA AMJAD ZAKARIA AL SEIDI M.D (NPI 1629826987)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629826987 NPI number — MISS JUMANA AMJAD ZAKARIA AL SEIDI M.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AL SEIDI
Provider First Name:
JUMANA
Provider Middle Name:
AMJAD ZAKARIA
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
M.D
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1629826987
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/06/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 ASHEVILLE ROAD, UNIT 527, CHESTNUTHILL
Provider Second Line Business Mailing Address:
UNIT 527
Provider Business Mailing Address City Name:
CHESTNUT HILL
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02467
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
857-999-6435
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
111 CENTRAL AVE, NEWARK NJ 07102 USA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-342-5212
Provider Business Practice Location Address Fax Number:
973-877-5367
Provider Enumeration Date:
05/10/2024

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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