Individual
MARYAM RAFIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 BERGEN ST, NEWARK, NJ 07103-2495
(201) 253-8979
Mailing address
21 COOPER ST, BAYONNE, NJ 07002-4411
(201) 253-8979
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02679900
NJ
Other
Enumeration date
05/14/2016
Last updated
01/03/2019
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