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General NPI Number Information
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NPI Number | 1487432878
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Entity Type | Individual
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Provider Name | TASWIYAH RA'OOF-SALEEM NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 09/18/2023
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 935 GARFIELD AVE
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City | JERSEY CITY
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State | NJ
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Zip | 07304-2731
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Country | US
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Telephone | 201-478-5800
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Fax | 201-478-5814
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Provider Business Mailing Address
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Address Line | 50A NEWARK WAY
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-3310
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Country | US
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Telephone | 973-885-0475
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 26NJ14844500
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License Number State | NJ
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