Provider Demographics
NPI:1427784453
Name:HAJ, MARIAM
Entity type:Individual
Prefix:
First Name:MARIAM
Middle Name:
Last Name:HAJ
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 1:120 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:NEWFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08344-2602
Mailing Address - Country:US
Mailing Address - Phone:866-530-7422
Mailing Address - Fax:
Practice Address - Street 1:120 PEARL ST
Practice Address - Street 2:
Practice Address - City:NEWFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08344-2602
Practice Address - Country:US
Practice Address - Phone:866-530-7422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-01
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA44SL06807500101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health