Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207KA0200X | Allergist | 25MA04135300 | NJ |
N | 207R00000X | Internist | 25MA04135300 | NJ |
N | 111NI0900X | Internist | 25MA04135300 | NJ |
N | 207RR0500X | Rheumatology | 25MA04135300 | NJ |
NPI | 1679521843 |
---|---|
Provider Name | Tariq Mahmood |
First Address | Union, NJ 07083-5714 |
Second Address | Union, NJ 07083-5718 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 12/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E53341 | (02) | NJ |