Provider Demographics
NPI:1891404042
Name:NISAR, UMAR (DC)
Entity type:Individual
Prefix:DR
First Name:UMAR
Middle Name:
Last Name:NISAR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:UMAR
Other - Middle Name:
Other - Last Name:NISAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:201 KRESSON GIBBSBORO RD STE 13
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-9588
Mailing Address - Country:US
Mailing Address - Phone:856-534-6953
Mailing Address - Fax:
Practice Address - Street 1:201 KRESSON GIBBSBORO RD STE 13
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-9588
Practice Address - Country:US
Practice Address - Phone:856-534-6953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00787700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor