Provider Demographics
NPI:1891021986
Name:MIRZA, NADIA M (MD)
Entity Type:Individual
Prefix:DR
First Name:NADIA
Middle Name:M
Last Name:MIRZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 525
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-0525
Mailing Address - Country:US
Mailing Address - Phone:201-683-6922
Mailing Address - Fax:201-526-8333
Practice Address - Street 1:25 POCONO RD
Practice Address - Street 2:ST CLARE'S HEALTH SYSTEM. DPT. OF RADIOLOGY
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2954
Practice Address - Country:US
Practice Address - Phone:973-983-5261
Practice Address - Fax:201-526-8333
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-23
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2606092085R0202X
NJ25MAO91185002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology