Provider Demographics
NPI:1346626959
Name:MOSAAD, TAMER
Entity Type:Individual
Prefix:
First Name:TAMER
Middle Name:
Last Name:MOSAAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 JOHN MILLER WAY STE 307
Mailing Address - Street 2:
Mailing Address - City:KEARNY
Mailing Address - State:NJ
Mailing Address - Zip Code:07032-6531
Mailing Address - Country:US
Mailing Address - Phone:551-202-4099
Mailing Address - Fax:
Practice Address - Street 1:78 JOHN MILLER WAY STE 307
Practice Address - Street 2:
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-6531
Practice Address - Country:US
Practice Address - Phone:551-202-4099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-05
Last Update Date:2020-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00524500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional