Provider Demographics
NPI:1477162097
Name:OBEIDALLAH, MUNEER KHALID (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:MUNEER
Middle Name:KHALID
Last Name:OBEIDALLAH
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-2709
Mailing Address - Country:US
Mailing Address - Phone:862-264-3851
Mailing Address - Fax:
Practice Address - Street 1:84 CLINTON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2709
Practice Address - Country:US
Practice Address - Phone:862-264-3851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-29
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01933200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist