Provider Demographics
NPI:1891472460
Name:ASFAND, MAHAM
Entity Type:Individual
Prefix:
First Name:MAHAM
Middle Name:
Last Name:ASFAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 DIANA CT
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-2823
Mailing Address - Country:US
Mailing Address - Phone:516-304-0980
Mailing Address - Fax:
Practice Address - Street 1:16 DIANA CT
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-2823
Practice Address - Country:US
Practice Address - Phone:516-304-0980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant