MEDICARE: MAA MEDICAL ASSOCIATES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician

General Provider Information

NPI Number	:	1053175000
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAA MEDICAL ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	459 OREGON ST
Second Line	:
City	:	PARAMUS
State	:	NJ
Zip	:	07652-5623
Country	:	US
Telephone Number	:	201-995-1005
Fax Number	:	201-995-1007

Provider Business Practice Location Address
First Line	:	400 FRANKLIN TPKE STE 104
Second Line	:
City	:	MAHWAH
State	:	NJ
Zip	:	07430-3517
Country	:	US
Telephone Number	:	201-995-1005
Fax Number	:	201-995-1007

Authorized Official
Title or Position	:	PROVIDER
Name	:	MADEEHA SHAHZADI
Credential	:
Telephone Number	:	973-816-6796

Provider Enumeration Date	:	02/09/2024
Last Update Date	:	02/06/2026

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Directions to “MAA MEDICAL ASSOCIATES LLC ” Practice Location

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