Healthcare Provider Details

I. General information

NPI: 1891870689
Provider Name (Legal Business Name): AMJAD NAZEER MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 HOWARD BLVD SUITE 103
MT ARLINGTON NJ
07856-1532
US

IV. Provider business mailing address

22 HOWARD BLVD SUITE 103
MT. ARLINGTON NJ
07856-1532
US

V. Phone/Fax

Practice location:
  • Phone: 973-398-0870
  • Fax: 973-398-4357
Mailing address:
  • Phone: 973-398-0870
  • Fax: 973-398-4357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMA45416
License Number StateNJ

VIII. Authorized Official

Name: AMJAD NAZEER
Title or Position: PRESIDENT
Credential: MD
Phone: 973-398-0870