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General NPI Number Information
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NPI Number | 1104716711
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Entity Type | Individual
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Provider Name | TAJUDDIN ABDULLAH
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Gender | Male
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Dates
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Enumeration Date | 07/07/2025
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 1221 N CHURCH ST UNIT 106
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City | MOORESTOWN
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State | NJ
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Zip | 08057-1245
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Country | US
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Telephone | 609-208-3053
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Fax |
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Provider Business Mailing Address
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Address Line | 33 W BROADWAY
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City | MAPLE SHADE
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State | NJ
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Zip | 08052-2302
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Country | US
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Telephone | 856-264-0762
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC01159900
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License Number State | NJ
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