Provider Demographics
NPI:1154485928
Name:ZULFIQAR, HAJIRA A (DMD)
Entity Type:Individual
Prefix:DR
First Name:HAJIRA
Middle Name:A
Last Name:ZULFIQAR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E GODFREY AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19120
Mailing Address - Country:US
Mailing Address - Phone:215-896-2535
Mailing Address - Fax:
Practice Address - Street 1:500 E GODFREY AVE
Practice Address - Street 2:SUITE B
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19120-2129
Practice Address - Country:US
Practice Address - Phone:215-745-9100
Practice Address - Fax:215-745-5177
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0366591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1022349970001Medicaid