Provider Demographics
NPI:1265446405
Name:ABDULLAH, MUHAMMAD (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:
Last Name:ABDULLAH
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 1:239 LAFAYETTE STREET
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105-1813
Mailing Address - Country:US
Mailing Address - Phone:973-690-5555
Mailing Address - Fax:973-690-5559
Practice Address - Street 1:239 LAFAYETTE STREET
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-1813
Practice Address - Country:US
Practice Address - Phone:973-690-5555
Practice Address - Fax:973-690-5559
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA68684207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG86771Medicare UPIN