Healthcare Provider Details

I. General information

NPI: 1598008948
Provider Name (Legal Business Name): HABIB A NAZIR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2013
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 LYONS AVE C8 - DEPARTMENT OF PULMONARY & CRITICAL CARE MEDICINE
NEWARK NJ
07112-2027
US

IV. Provider business mailing address

201 LYONS AVE C8 - DEPARTMENT OF PULMONARY & CRITICAL CARE MEDICINE
NEWARK NJ
07112-2027
US

V. Phone/Fax

Practice location:
  • Phone: 732-982-7510
  • Fax:
Mailing address:
  • Phone: 732-982-7510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA09900900
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number25MA09900900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: