Healthcare Provider Details

I. General information

NPI: 1053202119
Provider Name (Legal Business Name): AZZ MEDICAL ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2025
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 PENNINGTON RD STE 1
EWING NJ
08618-2669
US

IV. Provider business mailing address

PO BOX 830826
PHILADELPHIA PA
19182-0826
US

V. Phone/Fax

Practice location:
  • Phone: 609-890-1050
  • Fax: 609-890-0950
Mailing address:
  • Phone: 609-890-1050
  • Fax: 609-890-0950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: SHAHID B MEER
Title or Position: PRESIDENT
Credential: MD
Phone: 609-890-1050