Provider Demographics
NPI:1598537854
Name:ABDULHAMID, LATIFAH
Entity Type:Individual
Prefix:
First Name:LATIFAH
Middle Name:
Last Name:ABDULHAMID
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 STENGEL AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07112
Mailing Address - Country:US
Mailing Address - Phone:973-819-9510
Mailing Address - Fax:
Practice Address - Street 1:34 STENGEL AVE SUITE B
Practice Address - Street 2:SUITE B
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112
Practice Address - Country:US
Practice Address - Phone:973-819-9510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X, 175M00000X, 374J00000X, 374K00000X
NJ26NO07329800174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No171400000XOther Service ProvidersHealth & Wellness Coach
No175M00000XOther Service ProvidersMidwife, Lay
No374J00000XNursing Service Related ProvidersDoula
No374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner