Provider Demographics
NPI:1558306423
Name:MIRZA, NIGHAT (MD)
Entity Type:Individual
Prefix:DR
First Name:NIGHAT
Middle Name:
Last Name:MIRZA
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 1:1 NAMI LN STE 9
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-1251
Mailing Address - Country:US
Mailing Address - Phone:609-631-7770
Mailing Address - Fax:609-631-7774
Practice Address - Street 1:1 NAMI LN STE 9
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-1251
Practice Address - Country:US
Practice Address - Phone:609-631-7770
Practice Address - Fax:609-631-7774
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-17
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0530692084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ717813Medicare ID - Type UnspecifiedMEDICARE NUMBER