Provider Demographics
NPI:1740345990
Name:MOHAMMAD A. RAZA, M.D., PA
Entity type:Organization
Organization Name:MOHAMMAD A. RAZA, M.D., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-538-8116
Mailing Address - Street 1:1520 PENNINGTON RD
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-1307
Mailing Address - Country:US
Mailing Address - Phone:609-538-8116
Mailing Address - Fax:
Practice Address - Street 1:1520 PENNINGTON RD
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08618-1307
Practice Address - Country:US
Practice Address - Phone:609-538-8116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1034435OtherMERCY HEALTH PLAN
NJ13068OtherUNIVERSITY HEALTH PLAN
NJ1969307Medicaid
NJ0075298000OtherAMERIHEALTH
NJ13068OtherUNIVERSITY HEALTH PLAN
NJ1034435OtherMERCY HEALTH PLAN
NJD83248Medicare UPIN
NJ=========OtherHORIZON BC/BS NJ