MEDICARE: DR. FATIMA BUKHARI MD

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	25MA11773800	NJ

General Provider Information

NPI Number	:	1760018717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FATIMA BUKHARI MD

Provider Business Mailing Address
First Line	:	85 HARRISTOWN RD
Second Line	:
City	:	GLEN ROCK
State	:	NJ
Zip	:	07452-3329
Country	:	US
Telephone Number	:	201-201-4610
Fax Number	:

Provider Business Practice Location Address
First Line	:	85 HARRISTOWN RD
Second Line	:
City	:	GLEN ROCK
State	:	NJ
Zip	:	07452-3329
Country	:	US
Telephone Number	:	201-201-4610
Fax Number	:

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

Provider Enumeration Date	:	03/20/2020
Last Update Date	:	03/26/2025

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