Provider Demographics
NPI:1467491563
Name:QAZI, SADIA I (MD)
Entity Type:Individual
Prefix:
First Name:SADIA
Middle Name:I
Last Name:QAZI
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 1:445 WHITE HORSE AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08610-1408
Mailing Address - Country:US
Mailing Address - Phone:609-581-5502
Mailing Address - Fax:609-581-5504
Practice Address - Street 1:445 WHITE HORSE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08610-1408
Practice Address - Country:US
Practice Address - Phone:609-581-5502
Practice Address - Fax:609-581-5504
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA069626207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8478104Medicaid
NJH12520Medicare UPIN
NJ8478104Medicaid