MEDICARE: DR. TAYYABA K MALIK M.D.

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	208000000X	Pediatrics Physician	MA60432	NJ

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	:	1306956164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TAYYABA K MALIK M.D.

Provider Business Mailing Address
First Line	:	7 JENNA LN
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08820-1050
Country	:	US
Telephone Number	:	201-217-1000
Fax Number	:	201-217-3118

Provider Business Practice Location Address
First Line	:	127 PALISADE AVE
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-1101
Country	:	US
Telephone Number	:	201-217-1000
Fax Number	:

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	04/15/2023

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