Provider Demographics
NPI:1295737021
Name:ASLAM, TAHSEEN (MD)
Entity type:Individual
Prefix:DR
First Name:TAHSEEN
Middle Name:
Last Name:ASLAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 W GILBERT ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-4918
Mailing Address - Country:US
Mailing Address - Phone:721-212-0060
Mailing Address - Fax:732-212-0061
Practice Address - Street 1:155 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-1706
Practice Address - Country:US
Practice Address - Phone:973-589-1300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05284700207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7439504Medicaid
NJ03799UXLMedicare PIN
NJG61779Medicare UPIN
NJ7439504Medicaid
NJ003799MK3Medicare PIN
NJ003799P7GMedicare PIN
NJ003799UWXMedicare PIN
NJ003799UWYMedicare PIN
NJ003799UXKMedicare PIN
NJ03799DPHMedicare PIN
NJ003799UWWMedicare PIN