Healthcare Provider Details
I. General information
NPI: 1801200019
Provider Name (Legal Business Name): ASFI RAFIUDDIN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/16/2014
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20 PROSPECT AVE STE 800
HACKENSACK NJ
07601-1974
US
IV. Provider business mailing address
333 WESTCHESTER AVE STE E104
WHITE PLAINS NY
10604-2930
US
V. Phone/Fax
- Phone: 201-343-6676
- Fax: 201-343-6689
- Phone: 914-428-9213
- Fax: 914-428-9282
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | 25MB10910300 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084E0001X |
| Taxonomy | Epilepsy Physician |
| License Number | 25MB10910300 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: