Provider Demographics
NPI:1518086982
Name:LOKHAT, FATEMA ANJUM A (DPM)
Entity Type:Individual
Prefix:
First Name:FATEMA ANJUM
Middle Name:A
Last Name:LOKHAT
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5600 KENNEDY BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WESTNEWYORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-3529
Mailing Address - Country:US
Mailing Address - Phone:732-232-0854
Mailing Address - Fax:
Practice Address - Street 1:5600 KENNEDY BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:WESTNEWYORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-3529
Practice Address - Country:US
Practice Address - Phone:732-232-0854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00289800213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MD00289800OtherSTATE LISCENSE
NJ25MD00289800OtherSTATE LISCENSE