Healthcare Provider Details

I. General information

NPI: 1891948402
Provider Name (Legal Business Name): SALMAN M MUDDASSIR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2008
Last Update Date: 11/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 HAMILTON AVE
TRENTON NJ
08629-1915
US

IV. Provider business mailing address

PO BOX 1613
LEVITTOWN PA
19058-1613
US

V. Phone/Fax

Practice location:
  • Phone: 609-599-5061
  • Fax:
Mailing address:
  • Phone: 267-393-5265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberMA816930
License Number StateNJ

VIII. Authorized Official

Name: SALMAN M MUDDASSIR
Title or Position: ASSISTANT PROFESSOR OF MEDICINE
Credential: M.D.
Phone: 267-393-5265