Provider Demographics
NPI:1407919384
Name:BAKR, ABDUL K (MHS, CAC)
Entity Type:Individual
Prefix:MR
First Name:ABDUL
Middle Name:K
Last Name:BAKR
Suffix:
Gender:M
Credentials:MHS, CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 ROSEDALE AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08638-3527
Mailing Address - Country:US
Mailing Address - Phone:609-883-8202
Mailing Address - Fax:
Practice Address - Street 1:946 EDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-5304
Practice Address - Country:US
Practice Address - Phone:609-392-0945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health