Provider Demographics
NPI:1891870689
Name:AMJAD NAZEER MD PA
Entity Type:Organization
Organization Name:AMJAD NAZEER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMJAD
Authorized Official - Middle Name:
Authorized Official - Last Name:NAZEER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-398-0870
Mailing Address - Street 1:22 HOWARD BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MT. ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07856-1532
Mailing Address - Country:US
Mailing Address - Phone:973-398-0870
Mailing Address - Fax:973-398-4357
Practice Address - Street 1:22 HOWARD BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:MT ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07856-1532
Practice Address - Country:US
Practice Address - Phone:973-398-0870
Practice Address - Fax:973-398-4357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA45416207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0652008Medicaid
NJD06433Medicare UPIN
NJ0652008Medicaid