Provider Demographics
NPI:1043401680
Name:ABTAHI, MOHAMMED R (DC)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:R
Last Name:ABTAHI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 S FRANKLIN TPKE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-2550
Mailing Address - Country:US
Mailing Address - Phone:201-995-9900
Mailing Address - Fax:201-995-9901
Practice Address - Street 1:27 S FRANKLIN TPKE
Practice Address - Street 2:SUITE 302
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-2550
Practice Address - Country:US
Practice Address - Phone:201-995-9900
Practice Address - Fax:201-995-9901
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00659700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor