Provider Demographics
NPI:1013274034
Name:SALEEMI, ATIF (MD)
Entity Type:Individual
Prefix:
First Name:ATIF
Middle Name:
Last Name:SALEEMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 FORTUNE CT
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-1491
Mailing Address - Country:US
Mailing Address - Phone:732-318-7915
Mailing Address - Fax:
Practice Address - Street 1:9 MULE RD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-5043
Practice Address - Country:US
Practice Address - Phone:173-281-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-15
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35125245207Q00000X
NJ25MA10046600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3025372Medicaid
OHH386600Medicare PIN
OH3025372Medicaid