Provider Demographics
NPI:1306956164
Name:MALIK, TAYYABA K (MD)
Entity type:Individual
Prefix:DR
First Name:TAYYABA
Middle Name:K
Last Name:MALIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 JENNA LN
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1050
Mailing Address - Country:US
Mailing Address - Phone:201-217-1000
Mailing Address - Fax:201-217-3118
Practice Address - Street 1:127 PALISADE AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-1101
Practice Address - Country:US
Practice Address - Phone:201-217-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2023-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA60432208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6186106Medicaid
NJ6186106Medicaid
NJMA620354Medicare ID - Type Unspecified