Provider Demographics
NPI:1790993897
Name:ALFAKIR, MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:ALFAKIR
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 1:378 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:HALEDON
Mailing Address - State:NJ
Mailing Address - Zip Code:07508-1353
Mailing Address - Country:US
Mailing Address - Phone:973-925-4848
Mailing Address - Fax:973-925-4851
Practice Address - Street 1:378 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:HALEDON
Practice Address - State:NJ
Practice Address - Zip Code:07508-1353
Practice Address - Country:US
Practice Address - Phone:973-925-4848
Practice Address - Fax:973-925-4851
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-20
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08660200174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ179099Medicare UPIN
NJ242351Medicare PIN