MEDICARE: WAJIHAH MEMON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	OT022163	PA

General Provider Information

NPI Number	:	1265167811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WAJIHAH MEMON

Provider Business Mailing Address
First Line	:	138 SCHOOL ST
Second Line	:
City	:	PISCATAWAY
State	:	NJ
Zip	:	08854-5921
Country	:	US
Telephone Number	:	646-706-2278
Fax Number	:

Provider Business Practice Location Address
First Line	:	138 SCHOOL ST
Second Line	:
City	:	PISCATAWAY
State	:	NJ
Zip	:	08854-5921
Country	:	US
Telephone Number	:	646-706-2278
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2022
Last Update Date	:	06/02/2026

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