Provider Demographics
NPI:1952091746
Name:MOHAMMAD, MARYAM HLAL
Entity Type:Individual
Prefix:
First Name:MARYAM
Middle Name:HLAL
Last Name:MOHAMMAD
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 1:59 BURLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-2110
Mailing Address - Country:US
Mailing Address - Phone:629-444-3987
Mailing Address - Fax:
Practice Address - Street 1:59 BURLINGTON RD
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-2110
Practice Address - Country:US
Practice Address - Phone:629-444-3987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker