Provider Demographics
NPI:1235348996
Name:MOHIUDDIN, SAYEEDA TAJ (MD, FACOG)
Entity Type:Individual
Prefix:
First Name:SAYEEDA
Middle Name:TAJ
Last Name:MOHIUDDIN
Suffix:
Gender:F
Credentials:MD, FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 ERIE BLVD E
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1144
Mailing Address - Country:US
Mailing Address - Phone:315-472-9517
Mailing Address - Fax:315-472-9553
Practice Address - Street 1:1101 ERIE BLVD E
Practice Address - Street 2:SUITE 204
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1144
Practice Address - Country:US
Practice Address - Phone:315-472-9517
Practice Address - Fax:315-472-9553
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY161632207VH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VH0002XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyHospice and Palliative Medicine