Provider Demographics
NPI:1881807774
Name:MOHAMMED, DEBBIE YSMIN (DRPH,MS, MPH,)
Entity type:Individual
Prefix:DR
First Name:DEBBIE
Middle Name:YSMIN
Last Name:MOHAMMED
Suffix:
Gender:F
Credentials:DRPH,MS, MPH,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 EAGLE ROCK AVE UNIT 202D
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-6801
Mailing Address - Country:US
Mailing Address - Phone:973-343-5660
Mailing Address - Fax:973-343-5660
Practice Address - Street 1:569 NORTH 5TH STREET,
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07107-2630
Practice Address - Country:US
Practice Address - Phone:973-343-3660
Practice Address - Fax:833-978-0843
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNN098031363LP2300X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care