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Individual

SUBIKA MOHAMMAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
668 N BEERS ST, HOLMDEL, NJ 07733-1526
(732) 212-6598
Mailing address
63 MILLER RD, HOWELL, NJ 07731-2573
(732) 984-1676

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00441300
NJ
363AS0400X
Surgical Physician Assistant
25MP00441300
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
25MP00441300
STATE ISSUED LICENSE
NJ
Enumeration date
08/01/2017
Last updated
06/16/2018
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