Provider Demographics
NPI:1346430774
Name:AYUB, NUDRAT F (MD)
Entity type:Individual
Prefix:
First Name:NUDRAT
Middle Name:F
Last Name:AYUB
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 1:8 COVENTRY RD
Mailing Address - Street 2:
Mailing Address - City:MENDHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07945-1516
Mailing Address - Country:US
Mailing Address - Phone:973-351-6000
Mailing Address - Fax:973-351-6001
Practice Address - Street 1:50 UNION AVE STE 605
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-3262
Practice Address - Country:US
Practice Address - Phone:973-351-6000
Practice Address - Fax:973-351-6001
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08288800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0155055Medicaid
NJ46785OtherUHP- NON PAR #
NJ0155055Medicaid
NJ121630TS6Medicare PIN