Provider Demographics
NPI:1679544324
Name:LATEEF, ASLAM (MD)
Entity Type:Individual
Prefix:
First Name:ASLAM
Middle Name:
Last Name:LATEEF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 WHITEHORSE MERCERVILLE RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-1946
Mailing Address - Country:US
Mailing Address - Phone:609-584-9200
Mailing Address - Fax:609-584-9299
Practice Address - Street 1:2333 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:SUITE G
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-1946
Practice Address - Country:US
Practice Address - Phone:609-584-9200
Practice Address - Fax:609-584-9299
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-31
Last Update Date:2014-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07700100207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ082070Medicare PIN
NJI13440Medicare UPIN