Provider Demographics
NPI:1477644821
Name:ZEDIE, NISHAT (MD)
Entity Type:Individual
Prefix:
First Name:NISHAT
Middle Name:
Last Name:ZEDIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:285 DAVIDSON AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-4153
Mailing Address - Country:US
Mailing Address - Phone:732-271-1400
Mailing Address - Fax:732-271-3544
Practice Address - Street 1:240 EASTON AVE FL 3
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1723
Practice Address - Country:US
Practice Address - Phone:732-560-5400
Practice Address - Fax:732-271-3544
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA03329500207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0962902Medicaid
NJ206376A01Medicare PIN
NJ0962902Medicaid