MEDICARE: KHADIJA SALEEM

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	363A00000X	Physician Assistant	25MP00805900	NJ

General Provider Information

NPI Number	:	1669133781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KHADIJA SALEEM

Provider Business Mailing Address
First Line	:	301 LIPPINCOTT DR STE 410
Second Line	:
City	:	MARLTON
State	:	NJ
Zip	:	08053-4197
Country	:	US
Telephone Number	:	856-355-0340
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 BOWMAN DR LOWR LEVEL2
Second Line	:
City	:	VOORHEES
State	:	NJ
Zip	:	08043-9612
Country	:	US
Telephone Number	:	856-247-2160
Fax Number	:	856-247-2165

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

Provider Enumeration Date	:	01/02/2022
Last Update Date	:	06/09/2026

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Directions to “ KHADIJA SALEEM ” Practice Location

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