Provider Demographics
NPI:1578584736
Name:KADDAHA, RAJA'A (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJA'A
Middle Name:
Last Name:KADDAHA
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 1:999 MCBRIDE AVE
Mailing Address - Street 2:SUITE B204
Mailing Address - City:WEST PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-2570
Mailing Address - Country:US
Mailing Address - Phone:973-256-5667
Mailing Address - Fax:973-256-7758
Practice Address - Street 1:999 MCBRIDE AVE
Practice Address - Street 2:SUITE B204
Practice Address - City:WEST PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07424-2570
Practice Address - Country:US
Practice Address - Phone:973-256-5667
Practice Address - Fax:973-256-7758
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA72207207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8835501Medicaid
NJH44073Medicare UPIN
NJ8835501Medicaid