Provider Demographics
NPI:1750479705
Name:HAMEED, FAUZIA (MD)
Entity Type:Individual
Prefix:
First Name:FAUZIA
Middle Name:
Last Name:HAMEED
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 1:616 AMBOY AVE
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095-3164
Mailing Address - Country:US
Mailing Address - Phone:732-636-1010
Mailing Address - Fax:732-636-1018
Practice Address - Street 1:616 AMBOY AVE
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095-3164
Practice Address - Country:US
Practice Address - Phone:732-636-1010
Practice Address - Fax:732-636-1018
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2014-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06835600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH60815Medicare UPIN