Healthcare Provider Details

I. General information

NPI: 1477472439
Provider Name (Legal Business Name): SUHAILAH ABDUL AZIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 S HARRISON ST STE 400
EAST ORANGE NJ
07018-1411
US

IV. Provider business mailing address

280 S HARRISON ST STE 400
EAST ORANGE NJ
07018-1411
US

V. Phone/Fax

Practice location:
  • Phone: 862-253-3109
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: