Healthcare Provider Details

I. General information

NPI: 1639171457
Provider Name (Legal Business Name): ASAD M CHEEMA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 09/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

946 BLOOMFIELD AVE
GLEN RIDGE NJ
07028-1304
US

IV. Provider business mailing address

946 BLOOMFIELD AVE
GLEN RIDGE NJ
07028-1304
US

V. Phone/Fax

Practice location:
  • Phone: 973-743-1121
  • Fax: 973-743-9419
Mailing address:
  • Phone: 973-743-1121
  • Fax: 973-743-9419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number25MA07279500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number25MA07279500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: