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Individual

DAWLAT MATARI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
156 NEWARK POMPTON TPKE, PEQUANNOCK, NJ 07440-1327
(866) 389-2727
Mailing address
15 WHEELER RD, WAYNE, NJ 07470-8209
(862) 668-8413

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
26NJ00589000
NJ
363LF0000X
Family Nurse Practitioner
Primary
26NJ00589000
NJ

Other

Enumeration date
09/22/2015
Last updated
02/23/2021
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