Healthcare Provider Details

I. General information

NPI: 1104320522
Provider Name (Legal Business Name): ZAIN U MEMON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2018
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97 MAIN ST STE 102
CHATHAM NJ
07928-2421
US

IV. Provider business mailing address

1501 STALLION CIR E
TOMS RIVER NJ
08755-1609
US

V. Phone/Fax

Practice location:
  • Phone: 201-472-0685
  • Fax: 201-589-2260
Mailing address:
  • Phone:
  • Fax: 201-589-2260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number1104320522
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number25MA11408700
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number320125
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: