Provider Demographics
NPI:1063698959
Name:NAIM T NAZHA MD PC
Entity type:Organization
Organization Name:NAIM T NAZHA MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:NAIM
Authorized Official - Middle Name:TOUFIC
Authorized Official - Last Name:NAZHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-383-6033
Mailing Address - Street 1:411 NEW RD
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08225-1648
Mailing Address - Country:US
Mailing Address - Phone:609-383-6033
Mailing Address - Fax:609-383-1548
Practice Address - Street 1:801 NEW ROAD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1648
Practice Address - Country:US
Practice Address - Phone:609-407-5055
Practice Address - Fax:609-407-5056
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NAIM T NAZHA MD PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-10
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04569800207RH0003X, 2085R0001X
NJ241792085B0100X, 2085N0904X, 2085R0202X, 261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Multi-Specialty
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear RadiologyGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ52753001OtherDMERC NJ MEDICARE
NJ0013749Medicaid
NJ0057805OtherAETNA
NJ0013749Medicaid
NJ073854Medicare PIN