Provider Demographics
NPI:1972564078
Name:IQBAL, MOHAMMED SAJJAD (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:SAJJAD
Last Name:IQBAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:M SAJJAD
Other - Middle Name:
Other - Last Name:IQBAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:735 LINWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-3534
Mailing Address - Country:US
Mailing Address - Phone:201-670-1231
Mailing Address - Fax:201-612-0922
Practice Address - Street 1:735 LINWOOD AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3534
Practice Address - Country:US
Practice Address - Phone:201-670-1231
Practice Address - Fax:201-612-0922
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03165400208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics