Provider Demographics
NPI:1821268350
Name:AZHAR, SABA FATIMA (MD)
Entity Type:Individual
Prefix:MR
First Name:SABA
Middle Name:FATIMA
Last Name:AZHAR
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 1:26 LIVINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNY
Mailing Address - State:NJ
Mailing Address - Zip Code:07032-1809
Mailing Address - Country:US
Mailing Address - Phone:201-866-6770
Mailing Address - Fax:
Practice Address - Street 1:8100 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-4254
Practice Address - Country:US
Practice Address - Phone:201-866-6770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-12
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT188075207R00000X
NJ25MA08842800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine