Provider Demographics
NPI:1447561121
Name:MALIK, TAHSEEN RABIA (MD)
Entity Type:Individual
Prefix:DR
First Name:TAHSEEN
Middle Name:RABIA
Last Name:MALIK
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:831 KINGS HIGHWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WEST DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08096
Mailing Address - Country:US
Mailing Address - Phone:856-853-8730
Mailing Address - Fax:856-853-7063
Practice Address - Street 1:831 KINGS HWY
Practice Address - Street 2:SUITE 100
Practice Address - City:WEST DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08096-3162
Practice Address - Country:US
Practice Address - Phone:856-853-8730
Practice Address - Fax:856-853-7063
Is Sole Proprietor?:No
Enumeration Date:2010-06-28
Last Update Date:2013-05-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA70384207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G44773Medicare UPIN