Provider Demographics
NPI:1659824431
Name:RABIA S AWAN MD, PA
Entity Type:Organization
Organization Name:RABIA S AWAN MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RABIA
Authorized Official - Middle Name:SULTANA
Authorized Official - Last Name:AWAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-926-8228
Mailing Address - Street 1:101 ROXY AVE
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1939
Mailing Address - Country:US
Mailing Address - Phone:973-926-8228
Mailing Address - Fax:973-923-2061
Practice Address - Street 1:201 LYONS AVE STE D-3
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-2027
Practice Address - Country:US
Practice Address - Phone:739-268-2289
Practice Address - Fax:973-923-2061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-28
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty