Healthcare Provider Details

I. General information

NPI: 1164677829
Provider Name (Legal Business Name): LOKHAT PHYSICIANS GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2008
Last Update Date: 11/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1416 PARK AVE
PLAINFIELD NJ
07060-2911
US

IV. Provider business mailing address

1416 PARK AVE
PLAINFIELD NJ
07060-2911
US

V. Phone/Fax

Practice location:
  • Phone: 201-306-6048
  • Fax:
Mailing address:
  • Phone: 201-306-6048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number25MD00289800
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. FATEMA ANJUM A LOKHAT
Title or Position: MEMBER
Credential: DPM
Phone: 201-306-6048