Provider Demographics
NPI:1780628503
Name:NASHAT, MUQSITA (MD)
Entity Type:Individual
Prefix:
First Name:MUQSITA
Middle Name:
Last Name:NASHAT
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 1:1700 NOTTINGHAM WAY STE 108
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3501
Mailing Address - Country:US
Mailing Address - Phone:609-303-4870
Mailing Address - Fax:
Practice Address - Street 1:1700 NOTTINGHAM WAY STE 108
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3501
Practice Address - Country:US
Practice Address - Phone:609-303-4870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036113609207R00000X, 207RG0300X
PAMD442990207R00000X
NJ25MA08996300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036113609OtherSTATE PHYSICIAN LICENSE