Provider Demographics
NPI:1235126327
Name:MOBIN-UDDIN, OMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:OMAR
Middle Name:
Last Name:MOBIN-UDDIN
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 1:10 PLUM STREET
Mailing Address - Street 2:6TH. FLOOR SUITE 600
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901
Mailing Address - Country:US
Mailing Address - Phone:732-546-3910
Mailing Address - Fax:480-287-9735
Practice Address - Street 1:10 PLUM STREET
Practice Address - Street 2:6TH. FLOOR SUITE 600
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901
Practice Address - Country:US
Practice Address - Phone:732-546-3910
Practice Address - Fax:480-287-9735
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07590700207W00000X, 207WX0009X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP3012683OtherOXFORD
NJ2K5268OtherHEALTH NET
NJ075399Medicare PIN
NJH16167Medicare UPIN