MEDICARE: DR. HAJIRA A ZULFIQAR DMD

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	1223G0001X	General Practice Dentistry	DS036659	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154485928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAJIRA A ZULFIQAR DMD

Provider Business Mailing Address
First Line	:	500 E GODFREY AVE
Second Line	:	SUITE B
City	:	PHILADELPHIA
State	:	PA
Zip	:	19120
Country	:	US
Telephone Number	:	215-896-2535
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 E GODFREY AVE
Second Line	:	SUITE B
City	:	PHILADELPHIA
State	:	PA
Zip	:	19120-2129
Country	:	US
Telephone Number	:	215-745-9100
Fax Number	:	215-745-5177

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	09/28/2016

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