Provider Demographics
NPI:1346821410
Name:AYUB, MOMINA (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:MOMINA
Middle Name:
Last Name:AYUB
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:498A GENISTA AVE
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-4447
Mailing Address - Country:US
Mailing Address - Phone:609-576-0729
Mailing Address - Fax:
Practice Address - Street 1:161 BARTLEY RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-1241
Practice Address - Country:US
Practice Address - Phone:732-363-6140
Practice Address - Fax:732-363-6196
Is Sole Proprietor?:No
Enumeration Date:2021-04-19
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA12369500207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine