Healthcare Provider Details

I. General information

NPI: 1073691424
Provider Name (Legal Business Name): GHAZALA ARSHAD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 GERARD AVE
BRONX NY
10452-8001
US

IV. Provider business mailing address

385 HIGH ST
CLOSTER NJ
07624-2004
US

V. Phone/Fax

Practice location:
  • Phone: 718-960-2759
  • Fax: 718-960-2619
Mailing address:
  • Phone: 201-784-8396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number192914
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: