Provider Demographics
NPI:1346595915
Name:MALIK, GHAZALAH IQBAL (MD)
Entity Type:Individual
Prefix:
First Name:GHAZALAH
Middle Name:IQBAL
Last Name:MALIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 REDNECK AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE FERRY
Mailing Address - State:NJ
Mailing Address - Zip Code:07643
Mailing Address - Country:US
Mailing Address - Phone:201-925-1852
Mailing Address - Fax:
Practice Address - Street 1:142, REDNECK AVE.
Practice Address - Street 2:
Practice Address - City:LITTLE FERRY
Practice Address - State:NJ
Practice Address - Zip Code:07643
Practice Address - Country:US
Practice Address - Phone:201-925-1852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist