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General NPI Number Information
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NPI Number | 1376857177
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Entity Type | Individual
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Provider Name | AZIZEH J. SALLOUM MD
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Gender | Female
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Dates
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Enumeration Date | 08/04/2010
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Last Update Date | 10/21/2013
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Provider Practice Location Address
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Address Line | 1200 N HIGH ST
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City | MILLVILLE
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State | NJ
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Zip | 08332-2540
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Country | US
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Telephone | 856-451-4700
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Fax | 856-794-7183
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Provider Business Mailing Address
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Address Line | 53 S LAUREL ST
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City | BRIDGETON
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State | NJ
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Zip | 08302-1946
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Country | US
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Telephone | 856-451-4700
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Fax | 856-794-7183
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA09206900
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License Number State | NJ
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