Provider Demographics
NPI:1316151103
Name:ZAIDI, HASAN RAZA (DDS, MS)
Entity type:Individual
Prefix:
First Name:HASAN
Middle Name:RAZA
Last Name:ZAIDI
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 ELDRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-2600
Mailing Address - Country:US
Mailing Address - Phone:732-238-0239
Mailing Address - Fax:
Practice Address - Street 1:222 EASTON AVE
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1723
Practice Address - Country:US
Practice Address - Phone:732-246-0288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI023407001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice