Healthcare Provider Details

I. General information

NPI: 1922744895
Provider Name (Legal Business Name): UMME HAZERA APRN, FNP- BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2022
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 HAMBURG TPKE STE 203
WAYNE NJ
07470-2174
US

IV. Provider business mailing address

606 BROADWAY
PATERSON NJ
07514-1916
US

V. Phone/Fax

Practice location:
  • Phone: 973-569-6118
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ01232900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: