Provider Demographics
NPI:1093821969
Name:IQBAL, MASUD (MD)
Entity Type:Individual
Prefix:DR
First Name:MASUD
Middle Name:
Last Name:IQBAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 ROUTE 45
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NJ
Mailing Address - Zip Code:08079
Mailing Address - Country:US
Mailing Address - Phone:856-935-2000
Mailing Address - Fax:856-935-3233
Practice Address - Street 1:156 ROUTE 45
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NJ
Practice Address - Zip Code:08079
Practice Address - Country:US
Practice Address - Phone:856-935-2000
Practice Address - Fax:856-935-3233
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02527200207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2410588000OtherAMERI HEALTH
01000533600OtherAMERICHOICE
149158OtherBCBS
4090017OtherAETNA
1078969OtherHORIZON NJ HEALTH
NJ2760908Medicaid
1078969OtherHORIZON NJ HEALTH
NJ2760908Medicaid