Individual
KHALED MOHAMMAD KHALED BANI YASEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 CENTRAL AVE, NEWARK, NJ 07102-1909
(551) 250-3743
Mailing address
205 MOUNT VERNON AVE, ORANGE, NJ 07050-1711
(551) 250-3743
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/18/2024
Last updated
07/18/2024
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