Healthcare Provider Details

I. General information

NPI: 1831150671
Provider Name (Legal Business Name): MOUMINA AIROOD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 01/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

871 MCBRIDE AVE WEST PATERSON SPECIALITY CLINIC
WEST PATERSON NJ
07424-2745
US

IV. Provider business mailing address

871 MCBRIDE AVE WEST PATERSON SPECIALITY CLINIC
WEST PATERSON NJ
07424-2745
US

V. Phone/Fax

Practice location:
  • Phone: 973-569-4488
  • Fax: 973-569-4743
Mailing address:
  • Phone: 973-569-4488
  • Fax: 973-569-4743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMA071139
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: