Provider Demographics
NPI:1831293174
Name:MOAVEN, NADER (MD)
Entity Type:Individual
Prefix:
First Name:NADER
Middle Name:
Last Name:MOAVEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MOHAMMED
Other - Middle Name:NADER
Other - Last Name:MOAVEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5 FRANKLIN AVE
Mailing Address - Street 2:STE 302
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-3532
Mailing Address - Country:US
Mailing Address - Phone:973-759-1221
Mailing Address - Fax:973-759-1997
Practice Address - Street 1:5 FRANKLIN AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-3532
Practice Address - Country:US
Practice Address - Phone:973-759-1221
Practice Address - Fax:973-759-1997
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA58129207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ200231917OtherTAX ID
NJDO57071OtherCDS
NJ6436005Medicaid
NJ6436005Medicaid
NJDO57071OtherCDS
NJM0618208Medicare ID - Type Unspecified